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Quarter of teens have smoked, HKU study finds ($$) 

One in four Hong Kong teenagers has smoked, and second-hand smoke can aggravate respiratory symptoms even among smokers. These are the main findings of a University of Hong Kong study published in the latest issue of the journal Pediatrics.

Researchers from the university's school of public health said the study was the first to show that exposure to second-hand smoke was associated with increased risk of persistent respiratory symptoms among adolescent smokers.

Current smokers who were exposed to second-hand smoke at home for five to seven days a week were 77 per cent more likely to suffer from respiratory symptoms than those who were not exposed, researchers said. If they also encountered second-hand smoke outside home, the percentage of risk was even higher, at 85 per cent.

Some 32,506 people aged 11 to 20 were recruited from 85 randomly selected schools in 2003 and 2004 and asked to fill in a questionnaire. The survey revealed 24 per cent had smoked - 9 per cent who were currently smoking, 13 per cent who had tried smoking and 2 per cent who had kicked the habit.

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Secondhand smoke 

This article is part of the Tobacco portal on Sourcewatch, sponsored by the American Legacy Foundation. Help expose the truth about the tobacco industry.

Secondhand smoke, "also known as environmental tobacco smoke (ETS) or passive smoke, is a mixture of two forms of smoke from burning tobacco products," according to the American Cancer Society: Sidestream smoke, which is smoke that comes from a lighted cigarette, pipe, or cigar, and "mainstream smoke," the smoke the smoker himself inhales and exhales.[1]

Video on secondhand smoke produced by the U.S. Surgeon General

Contents

* 1 Secondhand smoke and human health

* 2 Cardiac effects

* 3 Tobacco industry toxicity testing not revealed to public

* 4 The "Biological Plausibility" Argument

* 5 Tobacco industry documents

* 5.1 R.J. Reynolds

* 5.2 Philip Morris

* 6 SourceWatch Resources

* 7 External links

* 7.1 General Information

* 8 References

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Secondhand smoke and human health

According to the U.S. Surgeon General, secondhand smoke contains a number of poisonous gases and chemicals, including hydrogen cyanide (used in chemical weapons), carbon monoxide (an odorless, colorless gas found in car exhaust), butane (used in lighter fluid), ammonia (used in household cleaners), and toluene (found in paint thinners). Eleven compounds in tobacco smoke have been identified by the International Agency for Research on Cancer as Group 1 Human Carcinogens. They are: 2-naphthylamine, 4-aminobiphenyl, benzene, vinyl chloride, ethylene oxide, arsenic, beryllium, nickel compounds, chromium, cadmium and polonium-210.[2]

In December 1992 the U.S. Environmental Protection Agency (EPA) issued a risk assessment titled "The Respiratory Health Effects of Passive Smoking," that concluded that secondhand smoke is a known human carcinogen which kills about 3,000 nonsmokers each year and is responsible for up 300,000 cases of bronchitis and pneumonia in children annually. The EPA's study stated that secondhand tobacco smoke is associated with increased risk of lower respiratory tract infections such as bronchitis and pneumonia. EPA estimated that 150,000 to 300,000 respiratory infections annually in infants and young children up to 18 months are attributable to secondhand smoke. EPA also concluded that secondhand smoke was associated middle ear effusions, upper respiratory tract irritation, and small reductions in lung function, and that it increased severity of asthma symptoms in children. EPA estimated that up to one million asthmatic children have their condition worsened by exposure to secondhand smoke and that tobacco smoke exposure may also be a risk factor for the development of new cases of asthma.[3]

"The U.S. Environmental Protection Agency (EPA) has classified secondhand smoke as a Group A Human carcinogen, which means that there is sufficient evidence to conclude that it causes cancer in humans. Environmental tobacco smoke has also been classified as a "known human carcinogen" by the U.S. National Toxicology Program.

"Secondhand tobacco smoke contains over 4,000 chemical compounds. More than 60 of these are known or suspected to cause cancer." [1]

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Cardiac effects

A 2001 study published in the Journal of the American Medical Association (JAMA) showed that inhaling secondhand smoke substantially reduced coronary flow velocity reserve in healthy nonsmokers. Coronary flow velocity reserve is a measure of the ability of the coronary arteries to dilate in order to increase blood flow in response to a stimulus or stressor. The cells that line blood vessels are called "endothelial cells," and a decline in coronary flow velocity reserve indicates "endothelial dysfunction," an impairment of the ability of the coronary arteries to dilate in response to a variety of stimuli. The 2001 study's authors conclude that this finding provides direct evidence that passive smoking may cause endothelial dysfunction of the coronary circulation in nonsmokers.[4]

A 2004 study published in the British Medical Journal (BMJ) revealed that people exposed to high levels of secondhand tobacco smoke (also known as "passive smoking") are more likely to develop coronary artery disease. Cotinine is a breakdown product of nicotine. The study found that people with higher concentrations of serum cotinine were 50-60% more likely to have coronary artery disease, but their risk of stroke was not increased. [5]

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Tobacco industry toxicity testing not revealed to public

In 2005, researchers and the University of California, San Francisco reviewed unpublished in vivo research on secondhand cigarette smoke performed by scientists at the Philip Morris Tobacco Company during the 1980s at its overseas biological lab Institut f�r Biologische Forschung, or INBIFO. Between 1981 and 1989 PM performed at least 115 studies at INBIFO on the toxicity of secondhand tobacco smoke. The existence of these studies on secondhand smoke was unknown until the tobacco industry's internal documents were made public on the Internet in 1998. The studies revealed that inhaled fresh secondhand smoke is approximately four times more toxic per gram in its total particulate matter than mainstream cigarette smoke (the smoke the smoker himself inhales). The condensate (commonly known as "tar") derived from secondhand smoke is approximately three times more toxic per gram and two to six times more tumorigenic per gram than the condensate produced by mainstream smoke when applied to skin. Philip Morris never revealed the results of these studies to the public or any government.[6]

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The "Biological Plausibility" Argument

Public acceptance of the scientific link between tobacco smoke and disease resulted in increasing public concern about the health effects of chronically inhalation of secondhand smoke in public places and on the job. The argument linking secondhand smoke with disease was known inside the industry as the "biological plausibility argument," and it goes like this:

1) Mainstream and secondhand smoke are chemically similar, 2) Mainstream and secondhand smoke both contain carcinogens, 3) Secondhand smoke consists of the same carcinogens, 4) Therefore it is biologically plausible that secondhand smoke causes lung cancer in nonsmokers.[7]

R.J. Reynolds chemist David J. Doolittle wrote in 1990:

When considering the biological plausibility model we must recognize two well-documented observations regarding ETS [environmental tobacco smoke]:

1) Some non-smokers are exposed to ETS as evidenced by subjective impressions (annoyance), and nicotine and cotinine in urine samples. 2) Even though present at very low concentrations, ETS does contain IARC [International Agency for Research on Cancer] human carcinogens, as well as mutagens and cytotoxins. Thus, we cannot disprove the notion that some non-smokers are exposed to carcinogens, mutagens, and cytotoxins in ETS. Also, even though the level of exposure to these chemicals is extraordinarily small, it is extremely difficult to absolutely prove that these exposures will never adversely affect any individual. This, in effect, forms the basis for the biological plausibility model.[8]

A 1999 Philip Morris report argues against the "Biological Plausibility" argument, saying "ETS [environmental tobacco smoke] has never been shown to be carcinogenic in any animal species." PM did not publicly reveal the results of over 100 in-house experiments it performed on ETS at INBIFO during the 1980s that concluded ETS was more toxic and carcinogenic than mainstream smoke.[9] . . .

R.J. Reynolds

In a 1994 brainstorming document, R. J. Reynolds sought to determine strategies the company could use to fight the emerging information that secondhand smoke is hazardous to health. In response to the question, "What is the most important strategy we [RJR] could take?" respondents answered,

* "We must incite smokers to rebel and spread that rebellion to nonsmokers now! We must be repetitious and persistent. All media, all intellectual levels. What do we have to lose?"

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ICD-9 Project 

The ICD-9 Project, also known as the "ICD-9 CM Issue," was an internal Philip Morris project to impede the creation of a medical billing code that would indicate illnesses that are attributable to secondhand tobacco smoke exposure. . . .

* The Proposal to Include Secondary Tobacco Smoke as an External Causative Agent, by Thorne Auchter of Philip Morris contractor Multinational Business Services, March 8, 1994, Bates No. 2046073521/3523] Memo to Mayada Logue of Philip Morris describing the ICD-9 situation and steps MBS had take to hinder creation of the code. . . .

Abstract: A new medical diagnostic code for secondhand smoke was created in 1994, but as of 2004 remained an invalid entry on a common medical form. The process for creating and utilizing medical codes is open to influence by lobbyists with undisclosed private industry clients. Tobacco industry documents reveal that Philip Morris budgeted over $2 million for an “ICD-9 Project” in the mid-1990s. Tactics to prevent adoption of the new code included third-party lobbying, Paperwork Reduction Act challenges, and backing an alternative coding system. A secondhand smoke code should be allowed on the Medicare form, and physicians should be made aware of its utilization within the new ICD-10 coding system.

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The Power Of Paperwork: How Philip Morris Neutralized The Medical Code For Secondhand Smoke  

A new medical diagnostic code for secondhand smoke exposure became available in 1994, but as of 2004 it remained an invalid entry on a common medical form. Soon after the code appeared, Philip Morris hired a Washington consultant to influence the governmental process for creating and using medical codes. Tobacco industry documents reveal that Philip Morris budgeted more than $2 million for this "ICD-9 Project." Tactics to prevent adoption of the new code included third-party lobbying, Paperwork Reduction Act challenges, and backing an alternative coding arrangement. Philip Morris's reaction reveals the importance of policy decisions related to data collection and paperwork.

Recently, the Bush administration has been subject to charges of "abuse of science."1 Science is vulnerable to pressure from politicians and from private industry.2 For example, decisions about data collection policy are often contested in the political arena by various interests.3 According to a Los Angeles Times story in 1995, one controversial case has been the tobacco industry's response to the collection of data on secondhand smoke.4 In December 1993 the U.S. government adopted a medical code for secondhand smoke as an external cause of illness or injury, in response to requests from coders and also in light of the Environmental Protection Agency's (EPA's) 1992 risk assessment of secondhand smoke.5 The tobacco industry responded swiftly.

To better understand the tobacco industry's involvement with the code, we conducted a search of once-private internal tobacco industry documents. . . .

The CMS form 1500 expires 31 march 2006 and will need OMB reapproval; this presents an opportunity to readdress the issue by allowing all E-codes, including secondhand smoke, back on the form.62 Successful lobbying by MBS has had a wide impact for different industries in which chemical exposures or occupational hazards are not documented. The agency will presumably solicit public comment on any changes to the form. The public health sector should be prepared to respond and to be attentive to any challenge to the form from private industry. Meanwhile, the ICD-10-CM, when it comes into use, contains some major changes in medical coding.63 The secondhand smoke exposure code will be found under Z58.83.64

The tobacco industry has thus far undermined the collection of data on secondhand smoke's relationship to illness. These findings exemplify the use of politics to influence science. The medical and public health communities need to be made aware of these different codes and the potential for tobacco industry interests to undermine their use.

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Form 10-Q Quarterly Report  

Overview

The condensed consolidated financial statements (unaudited) include the accounts of Reynolds American Inc., referred to as RAI, and its wholly owned operating subsidiaries. RAI’s wholly owned subsidiaries include R. J. Reynolds Tobacco Company; Santa Fe Natural Tobacco Company, Inc., referred to as Santa Fe; Lane, Limited, referred to as Lane; Conwood Holdings, Inc.; and Conwood Company, LLC and Rosswil LLC, collectively referred to as the Conwood companies.

RAI was incorporated as a holding company in the state of North Carolina on January 5, 2004, and its common stock is listed on the NYSE under the symbol “RAI.” RAI was created to facilitate the business combination of the U.S. business of Brown & Williamson Holdings, Inc., referred to as B&W, with R. J. Reynolds Tobacco Company on July 30, 2004.

References to RJR Tobacco prior to July 30, 2004, relate to R. J. Reynolds Tobacco Company, a New Jersey corporation and a wholly owned subsidiary of R.J. Reynolds Tobacco Holdings, Inc., referred to as RJR. References to RJR Tobacco on and subsequent to July 30, 2004, relate to the combined U.S. assets, liabilities and operations of B&W and R. J. Reynolds Tobacco Company, a North Carolina corporation.

RAI’s reportable operating segments are RJR Tobacco and Conwood. The RJR Tobacco segment consists of the primary operations of R. J. Reynolds Tobacco Company. The Conwood segment consists of Conwood Holdings, Inc., the primary operations of the Conwood companies and Lane. RAI’s wholly owned subsidiary, Santa Fe, among others, is included in All Other. The segments were identified based on how RAI’s chief operating decision maker allocates resources and assesses performance. Some of RAI’s wholly owned operating subsidiaries have entered into intercompany agreements for products or services with other RAI operating subsidiaries. As a result, certain activities of an operating subsidiary may be included in a different segment of RAI. . . .

Various legal proceedings or claims, including litigation claiming that cancer and other diseases, as well as addiction, have resulted from the use of, or exposure to, RAI’s operating subsidiaries’ products, are pending or may be instituted against RJR Tobacco, the Conwood companies or their affiliates, including RAI and RJR, or indemnitees, including B&W. These pending legal proceedings include claims relating to cigarette products manufactured by RJR Tobacco or certain of its affiliates and indemnitees, as well as claims relating to smokeless tobacco products manufactured by the Conwood companies. A discussion of the legal proceedings relating to cigarette products is set forth below under the heading “— Litigation Affecting the Cigarette Industry.” All of the references under that heading to tobacco-related litigation, smoking and health litigation and other similar references are references to legal proceedings relating to cigarette products and are not references to legal proceedings involving smokeless tobacco products, and case numbers under that heading include only cases involving cigarette products. The legal proceedings relating to the smokeless tobacco products manufactured by the Conwood companies are discussed separately under the heading “— Smokeless Tobacco Litigation” below.

In connection with the B&W business combination, RJR Tobacco has agreed to indemnify B&W and its affiliates, including its indirect parent, British American Tobacco p.l.c., referred to as BAT, against certain liabilities, costs and expenses incurred by B&W or its affiliates arising out of the U.S. cigarette and tobacco business of B&W. As a result of this indemnity, RJR Tobacco has assumed the defense of pending B&W-specific tobacco-related litigation, has paid the judgments and costs related to certain pre-business combination tobacco-related litigation of B&W, and has posted bonds on behalf of B&W, where necessary, in connection with cases decided since the B&W business combination. In addition, pursuant to this indemnity, RJR Tobacco expensed less than $1 million during each of the first nine months of 2009 and 2008 for funds to be reimbursed to BAT for costs and expenses incurred arising out of certain tobacco-related litigation.

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PROHIBIT SMOKING IN OUTDOOR DINING AREAS 

Motion - That the City Attorney be requested to prepare and present an ordinance to prohibit smoking in outdoor dining areas and within five feet of such areas, similar to a recent ordinance enacted by the City of Burbank. . . .

Date Activity 10/22/2009 Arts, Parks, Health and Aging Committee scheduled item for committee meeting on October 27, 2009.

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L.A.'s Outdoor Smoking Ban Proposal is Back 

A Los Angeles city council committee will look into the long-delayed outdoor smoking ban draft ordinance this morning. If approved, it will then move on to the full city council where if passed, the ban will go into affect after a six-month education campaign.

Basically, the ban says no smoking--unless you're just walking by--within 10 feet of an established outdoor dining area (think restaurants and cafes with sidewalk dining or outdoor food courts). For undefined dining areas like a food truck or cart, smoking will be verboten within 40 feet (that's because the location of the truck or cart has its own 30-foot radius). So no lighting up while in line for Kogi BBQ, kids.

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Clove Makers All Like, 'What Cigarettes?'  

Here you see a photo of kreteks, the kind of cloves everyone smokes in the USA. See them? They are cigarettes. But Kretek International is now suing the FDA to get them branded "Cigars," because, the WSJ points out, "The wrapper is homogenized leaf, the tobacco air-cured, and the finished product comes in boxes of 12, not 20."

Try this: Take a dozen clove cigarettes and put them in a box. Now look at them again. Have they magically been transformed into cigars? No? Damn it. Well, don't get too upset, hippies. Consider it part of your government-mandated path towards becoming Marlboro addicts.

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• More Scottish women die of lung cancer 

Soaring numbers of Scottish women are dying of lung cancer despite survival rates among men improving significantly, new figures show.

The increase also bucks the trend for death rates from other types of cancer north of the Border, all of which are going down.

Lung cancer deaths in men plummeted by 21 per cent in the 10 years to 2008, but increased by more than 11 per cent among women. . . .

However, the figures also reinforced major health differences across Scotland, with those living in the poorest areas 40 per cent more likely to have cancer than those in the wealthiest neighbourhoods.

Death rates in the most deprived communities are 75 per cent higher than those in the richest areas.

Dr Richard Simpson, Scottish Labour health spokesman, said: "I welcome the general improvement in cancer survival rates, but I am both disappointed and deeply concerned that more women are dying of lung cancer.

"This mainly reflects the increase in smoking among women over the past 20 years."

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• Palestine City Council OKs Smoking Ban  

Smoking in public places, places of employment and some outdoor areas will be prohibited here under an ordinance adopted Monday by Palestine City Council. Bars, nightclubs and some other places are exempted from the smoking ban.

The ordinance further makes it unlawful to smoke within 20 feet of outside entrances, operable windows and ventilation systems of enclosed areas where smoking is prohibited.

In an unrelated action, the council extended hours for the sale of mixed beverages to 2 a.m.

The nonsmoking order, passed by a majority of councilmembers with two nay votes, makes employers responsible for providing a smoke-free workplace for employees.

It charges the owner, manager or other persons in control of a public place or a place of employment to post "No Smoking" signs conspicuously at the entrance.

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Cigarette companies manipulate legislation, profs. say 

Federal regulation of cigarettes will not ultimately result in a safer cigarette or decrease the number of smokers, partially due to the large part tobacco companies played in drafting the legislation, professors said.

For example, the Family Smoking Prevention and Tobacco Control Act, signed into law on June 22, allows the FDA to ban fruit and candy flavored cigarettes and prohibits tobacco companies from using terms such as "light" on the packages.

Harvard School of Public Health professor Gregory Connolly said the bill is merely regulating a lethal product under the approval of the tobacco industry instead of developing a safer cigarette at a discussion with three other panelists on Friday at the School of Public Health to an audience of about 50 attendees.

"This law has moved the responsibility from the hands of the industry to the hands of the FDA," Connolly said.

American Legacy Foundation founding President and chief executive officer Cheryl Healton agreed that the federal regulation of cigarettes is quite unusual. . . .

The legislation also requires tobacco companies to reduce the number of carcinogens in their products.

BU School of Public Health professor Michael Siegel said this approach would make sense if cigarettes were composed of three chemicals instead of 10,000.

"There is no way of knowing which chemical actually make a difference," Siegel said. "Instead of companies saying that their cigarette now have reduced carcinogens, now the FDA is mandating it, potentially giving the impression that cigarettes are now safer."

BU School of Public Health graduate student Dan Lustick said he enjoyed the discussion on how corporate influence in Congress affects the final draft of the bill. . . .

Democracy Institute founding director Patrick Basham said FDA regulation of cigarettes is essentially preventing the creation of a safer cigarette.

"The new FDA regulation does not accommodate the fact that smoking is here for the long run," Basham said. "It practically guarantees that no safe cigarette can reach the public."

Siegel said this law was not worth passing because the companies had too much influence on the outcome.

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EDDIE: Open letter to the Tobacco Workgroup  

We write this open letter on behalf of Students for Sensible Drug Policy, a campus group that promotes sensible and effective approaches to policies regarding tobacco and other drugs. Naturally, our members are concerned about the efforts to ban smoking on the Morningside campus. More important than our stance on the issue, however, is our concern with the process by which this policy change may take place.

As we understand, a survey to gauge student opinion was sent last spring, receiving less-than-impressive levels of response. In addition, a town hall meeting was held last week. While all attendees of the meeting opposed the current proposal, according to the straw poll survey conducted, the turnout was still relatively low.

We believe this reaction is a result of the timing and advertisement of the e-mail and town hall meeting, and not indicative of the opinions of the student body. . . .

Despite what the town hall meeting and initial survey might suggest, our group maintains that the student body is far from apathetic. A few weeks ago, our group hosted an event on the steps of Low to raise awareness of the proposed ban. In just over one hour, we were able to collect the names and signatures of 75 students who opposed the proposal. We believe that our ability to collect signatures at such a high rate—more than one per minute—demonstrates that there is strong campus interest about this issue. The problem is that students are unaware of any ways to vocalize their thoughts to the administration and the Tobacco Workgroup.

Given the importance of this proposal and the large impact it would have on smokers and nonsmokers alike, as well as for cultural groups on campus that smoke hookah, we would like to open the path for dialogue about the proposal between the student body, the administration, and the Tobacco Workgroup.

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Heart attacks blamed on 2nd-hand smoke 

Second-hand smoke is the culprit in some 20 percent of heart attack cases in Metro Manila, health officials revealed on Monday as they called for the participation of local government leaders to implement 100 percent smoke-free policies in their areas of jurisdiction.

From January to February this year, the World Lung Foundation (WLF) and Paris-based organization The Union surveyed the magnitude of smoking and its effects on the residents of Metro Manila.

The study also found that more than half of the people in the metropolis inhale second-hand smoke every day. Seventy-four percent are exposed to it one or more times per week but only 8 percent complain about it.

"Tobacco is taking a devastating toll in the Philippines and people are dying every day, even those who don't use tobacco. The way to reverse this epidemic is through proven policies such as creating 100 percent smoke-free public places and work places," Department of Health (DoH) Secretary Francisco T. Duque III told the press in a conference in Tayuman, Manila on Monday.

Bloomberg Philanthropies is giving the DoH $740,000 to facilitate anti-tobacco strategies especially to ensure effective implementation of Republic Act 9211 or the Tobacco Regulation Act of 2003.

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Nailsea pub Blue Flame smoking shelter ban  

Nailsea pub landlord may have to pull down a smoking shelter he put up outside his inn as councillors said it "adversely affected the character of the area".

Mick Davidson, who has run the Blue Flame pub at Netherton Wood Lane, West End, Nailsea, for 21 years, put up the pergola style shelter at the front of the pub a couple of months ago after customers complained that they had nowhere dry to enjoy a cigarette.

Mick had previously put up gazebos at the front of the pub for smokers, but was forced to take them down after they blew over in high winds.

He then decided to create the wooden shelter, which has a metal and felt roof and is concreted into the ground, in front of the main bar where his smokers gather for a puff outside the pub.

But the future of the shelter - and whether it can stay put - is in the balance after complaints from local residents.

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CHURCHWELL: State smoking ban must go further 

As a cardiologist, I've seen firsthand the damage that smoking does to the body. Most patients I have taken care of who have had a heart attack or developed an acute coronary syndrome have a history of smoking or have been in an environment where secondhand smoke is a major issue in their lives. . . .

A study released by the Institute of Medicine earlier this month revealed that smoking bans in public places are effective at reducing the risk of heart attacks associated with exposure to secondhand smoke. . . .

Tennesseans should take this news as a call to action and demand that exemptions to the Non-smoker Protection Act be removed. The societal and financial costs to all of us are too great to continue to ignore. You can get involved and help make Tennessee a healthier place to live and work. CHART, the Campaign for a Healthy and Responsible Tennessee, is building its coalition of supporters to make all Tennessee workplaces smoke-free.

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