Monthly Archives: July 2009

Tobacco industry disinformation: Past & present

As a scientist, I’m trained not to dismiss evidence just because it contradicts my own beliefs about matters of fact, so when I first became actively involved in the secondhand smoke issue 25 years ago, if I read tobacco industry claims contrary to other evidence, my first reaction was to give them the benefit of the doubt.

That quickly changed after I learned they were only interested in spreading disinformation to protect their profits. It’s still happening today, as I observed last Tuesday during the public portion of St. Louis County Council’s meeting, only now it’s not tobacco industry lobbyists, who lost credibility years ago, it’s surrogates like Mr. Bill Hannegan.

Is this a fair assessment? I think it is, because what I’m seeing repeatedly with Mr. Hannegan is a willingness to use disputed or debunked science as a way to derail smoke-free air efforts locally.

When the scientific community was focused on research into the adverse health effects of active smoking, the industry’s focus was on creating a false dichotomy in that area. Once the damning evidence on active smoking became overwhelming, the focus shifted to involuntary smoking, or what the industry preferred to call “environmental tobacco smoke,” to suggest it’s just a fact of life. The term now preferred by the scientific community is “secondhand smoke.”

I was thinking about this today after having spent several days researching a published paper quoted by Mr. Hannegan during his pitch to St. Louis County Council on Tuesday, July 21, 2009. He referenced the work of Dr. Roger Jenkins, Oak Ridge National Laboratory – known as the “16-cities study” – which purported to show that exposure to secondhand smoke in 16 cities, including St. Louis, was at WORST no more than the equivalent of “1 cigarette per week,” according to Mr. Hannegan.

The purpose in quoting such questionable studies is no different from Big Tobacco’s: creating doubt about the underlying science of secondhand smoke to weaken support for government regulation.

As I noted above, this is not new. I was reviewing a GASP newsletter from January 1985, not long after our formation, when we were called St. Louis GASP and before approval of not-for-profit status, obtained in 1986, and found an interesting tobacco industry ad. and a published scientific rebuttal.

The TV Guide of June 16-20, 1984, had an R. J. Reynolds Tobacco Co. ad. headed Second-hand smoke: Let’s clear the air. The copy continued:

There is little evidence – and certainly nothing which proves scientifically – that cigarette smoke causes disease among non-smokers.

You don’t have to take our word for it.

This was followed by quotes attributed to U.S. Surgeon General Julius B. Richmond, Surgeon General C. Everett Koop, and Dr. Claude Lenfant, director of the National Heart, Lung and Blood institute, all appearing to support the assertions in the ad.

The doubt this created in my mind only changed after reading a paper about tobacco industry misinformation by Ernster & Burns called: A Rebuttal to the Tobacco Industry’s Paper, “Cigarette Smoke and the Nonsmoker” published in the Journal of Public Health Policy, September 1984, pp 368-375.

Subsequently the original ad, marked up with excerpts from the paper by Ernster & Burns directly rebutting its claims, plus their complete article, was included in the St. Louis GASP January 1985 newsletter and is just as relevant today.

One page of the GASP newsletter shows the industry ad., reproduced unamended except for some embellishment, and alongside it directly relevant rebuttals from the Ernster & Burn’s paper. I reproduce the page below, followed by the entire paper.

That same year, I was further informed about the tobacco industry and its deception in The Smoke Ring – Tobacco, Money & Multinational Politics by British investigative reporter, Peter Taylor, with an introduction by Dr. Koop. Since that time I’ve not trusted the tobacco industry as far as I could throw it. It looks like Mr. Hannegan is vying to replace them.

Note: In case the text of the ad. is unclear on-screen, I’ve extracted the underlined sections and followed each with Ernster & Burns’ rebuttals:

RJR ad: USSG Julius Richmond’s 1979 Report: “Healthy non-smokers exposed to cigarette smoke have little to no physiologic response to the smoke, and what response does occur may be due to psychological factors.”

Ernster & Burns’ rebuttal: “The latter statement referred only to the changes in heart rate and blood pressure found in children and was not suggested in relation to other health effects, nor was it one of the overall conclusions of the report. Moreover, it was written before some important studies linking involuntary exposure with disease were published.” page 373

RJR ad: “SG C. Everett Koop could not conclude that passive smoking is a cause of cancer in non-smokers.”

Ernster & Burns’ rebuttal: “They chose not to cite the Surgeon General’s full conclusion, i.e.: “Although the currently available evidence is not sufficient to conclude that passive or involuntary smoking causes lung cancer in nonsmokers, the evidence does raise concern about a possible serious public health problem” (5). They also ignored the foreward to the report by Assistant Secretary for Health, Edward Brandt, M.D., who stated:

While the nature of this association is unresolved, it does raise the concern that involuntary smoking may pose a carcinogenic risk to the nonsmoker. Any health risk resulting from involuntary smoke exposure is a serious public health concern because of the large numbers of nonsmokers in the population who are potentially exposed. Therefore, for the purposes of preventive medicine, prudence dictates that nonsmokers avoid exposure to second-hand tobacco smoke to the extent possible. p 371

RJR ad: Dr. Lenfant stated in 1980 … “the evidence that passive smoking in a general environment has health effects remains sparse, incomplete and sometimes unconvincing.”

Ernster & Burns’ rebuttal: However, reading the entire editorial from which this quote was taken gives the reader a different impression. Dr. Lenfant went on to say:

The article by White and Froeb…brings a new dimension that will clearly have considerable impact; they faultlessly demonstrate a reduction in measures of small airways of healthy nonsmokers exposed to cigarette smoke in the workplace … now, for the first time, we have a quantitative measurement of physical change — a fact that may tip the scales in favor of the nonsmokers (4). page 369

RJR ad 1984: Secondhand smoke - Lets clear the air

RJR ad 1984: Secondhand smoke - Lets clear the air

Ernst & Burns "A Rebuttal....." p368 Ernst & Burns: "A Rebuttal...." p369 Ernst & Burns: "A Rebuttal...." p370 Ernst & Burns: "A Rebuttal...." p371 Ernst & Burns: "A Rebuttal...." p372 Ernst & Burns: "A Rebuttal...." p373 Ernst & Burns: "A Rebuttal...." p374 Ernst & Burns: "A Rebuttal...." p374

St. Louis County Council considers smoke-free air bill

Out of the blue, the St. Louis County Council stepped into the secondhand smoke limelight when Councilwoman Barbara Fraser introduced a smoke-free air bill on Tuesday night [July 21, 2009]. If approved, it would mean voters will have a chance to vote on a county bill in the November elections.

The first hint I got of this was inadvertent: I happened to refresh a page on my computer as I was preparing to do one last thing before retiring at 12:30 am that Tuesday morning, only to see this headline staring at me:

St. Louis County may put smoking on ballot

The story, by St. Louis Post-Dispatch reporter Paul Hampel, kept me up until 2 am!

I was already planning to meet with one of the county legislators that afternoon to discuss the subject of secondhand smoke but this initiative floored me, since I have good relations with Councilwoman Fraser and I would have expected some notice of her intentions. It was apparently a hurried decision, possibly because there isn’t much time for county council approval to get it on the November ballot.

At this stage, there is no draft bill, only a placeholder, so I cannot judge the merits of the proposed legislation, but nonetheless I felt it worthwhile testifying in favor during the public comments portion of the county council’s meeting that evening, when members of the public have three minutes to address the council. (I’ve pasted my comments below in full.)

I was the first speaker called and the only other person to address the council that evening during the public comment period was Mr. Bill Hannegan, a vigorous opponent of smoke-free air already known to readers of mogasp’s blog (e.g. see “Hannegan continues SHS deception” posted on July 12, 2009). I was able to find a good synopsis of his comments posted on the county council website the following day here – quick work by St. Louis County personnel! – and I’ve pasted them below ahead of my own testimony.

After we each addressed the county council Mr. Hannegan and I were interviewed in turn outside the council chamber by KMOV News 4 reporter, Mark Schnyder, and the story was near the top of the 10 o’clock news on Tuesday evening and also posted on the KMOV website here.

News 4 reporter Mark Schnyder outside St. Louis Cty. Gov. Ctr.

Reporter Mark Schnyder outside St. Louis County Government Center, Clayton

Councilwoman Barbara Fraser before start of meeting

Councilwoman Barbara Fraser (center left) during county council meeting

Mr. Bill Hannegan during interview outside council chamber

Mr. Bill Hannegan during interview outside council chamber

Bill Hannegan:
“I’m worried about the County bars. I don’t want to see them stuck with a smoking ban and St. Louis City bars have no ban at all. Or any business, I would like to see each business make up their own mind and set their own policy.”

Martin Pion being interviewed outside council chamber

Martin Pion being interviewed outside council chamber

Martin Pion:
“This is just like a virus. The only difference is that you just put up a sign, take away the ashtrays, and problem gone. It’s not complicated science.”

The following is the St. Louis County Council transcript of Mr. Hannegan’s address, as officially recorded in the minutes of the meeting on the web:

“Mr. Bill Hannegen (sic), 5399 Lindell, St. Louis, MO, representing Keep St. Louis Free, addressed the County Council and related his discussion this date with Mr. Roger Jenkins, “a lead Scientist with the Department of Energy’s Oak Ridge National Laboratory”. Mr. Hannegen stated that Mr. Jenkins’ group did a study of 16 cities, with St. Louis included among the cities, to determine how much smoke employees in the cities across the country were actually being exposed to. He stated that the most smoke exposure the study could find was equivalent to one cigarette per week, which was located in a very smokey bar with no ventilation or air filtration.
Mr. Hannegen stated that air filtration is very affordable and is being employed throughout St. Louis County, and that air filtration can bring out the high point of one cigarette a week down to a very, very tiny fraction. Mr. Hannegen stated that bars and restaurants across St. Louis City and County are putting in the
air filtration machines, “they take out not only the second-hand smoke but all the other concerning airborne hazards, swine flu, they take 100% of swine flu out of the air of any bar or restaurant. That certainly is a concern coming up this Fall as St. Louis is threatened with a swine flu pandemic.”
Mr. Hannegen also shared his understanding of St. Louis City’s attempts to implement a smoking ban, noting that he does not think the St. Louis City bars will be included in its smoking ban. Mr. Hannegen expressed his concerns related to a strict smoking ban being voted in by St. Louis County residents and the resultant restrictions that would then hinder St. Louis County government from altering this ban at a later date. He proposed that the St. Louis County Council itself pass a smoking ban if necessary which would then allow the St. Louis County Council to make changes to the ban at a later date.”

Evidently, Mr. Hannegan has contacted Dr. Roger Jenkins, a scientist who has frequently conducted studies in collaboration with and for the tobacco industry, including the well-known “16-cities” study cited. I’ll deal with that and some of his other comments in greater detail in another blog to follow.

As to Mr. Hannegan’s statement that if a smoke-free referendum in November was successful the council would not be able to easily amend it, here’s an e-mail reply I received from Patricia Redington, County Counselor:

Subject: RE: Legal question re. petition initiative not allowing subsequent council amendment 
Date: July 22, 2009 5:00:22 PM CDT

Dear Mr. Pion –
The St. Louis County Charter does not prohibit repeal or modification of voter-approved ordinances.  I have not researched the case law on this matter.
Pat Redington

Below is the full text of my address to the County Council. Each member of the Council received a copy prior to the meeting. Note that County Executive Charlie Dooley was absent so I omitted reference to him in my opening address:

Testimony during Public Comments of St. Louis County Council Meeting of Tuesday, July 21, 2009, by Martin Pion, President, Missouri Group Against Smoking Pollution.

“Madam Chairman & Members of the council:

Let me first thank you for considering this important public health issue and Councilwoman Barbara Fraser for initiating it.

I’d like to begin by briefly putting this into historical perspective. In 1987, tobacco lobbyist John Britton nearly succeeded in passing a very weak state Clean Indoor Air law with preemption which would have forbidden any stronger local ordinance. Weak preemptive state laws were a nationwide strategy of the tobacco lobby at the time and Missouri GASP, of which I’m president, played a major role in defeating it in Missouri.

Then in 1993, the Missouri Clean Indoor Air Act passed without preemption, and that generated a lot of activity throughout the state, including metro St. Louis, with many jurisdictions not only adopting the state law but strengthening it. 

St. Louis County was no exception. In 1995, over strong tobacco industry opposition, it enacted an ordinance making all county-controlled buildings and vehicles smoke-free. Before that, smoking was allowed in this building, the County Government Center, for example.

In 2005 St. Louis County Council considered a bill to substantially extend smoke-free air protection to the private workplace. By then the tobacco industry had lost credibility so it was up to surrogates to whom they are closely allied, or others who were persuaded they would lose business, to fight the proposal. 

James Repace, an internationally recognized expert on the science of secondhand smoke, gave a compelling half-hour PowerPoint presentation at a hearing before the Justice and Health Committee in April 2005 on behalf of Missouri GASP. 

The bill finally came to a vote in August, 2005, when this council chamber was jammed with employees bussed in by Harrah’s Casino to oppose it. After a very lengthy public comments portion the bill was defeated 4:3. A similar bill introduced the following year was also defeated.

County Executive, Charley Dooley, made it known that he opposed these efforts then and remains so today. That opposition is apparently based on concern for the negative impact on business and resulting loss in tax revenue. I suggest Mr. Dooley reviews the experience of New York CIty, which passed a comprehensive smoke-free air ordinance years ago and has not seen these effects. In fact, when I spoke to a representative of the New York Restaurant Association some years ago he said they no longer opposed the NYC ordinance. 

In conclusion, I would prefer that you emulate Clayton and enact a comprehensive smoke-free air ordinance to protect the public health, but if that’s not politically feasible, we would support a public referendum.”

Kirkwood unanimously rejects smoke-free air petition

Asbestos, or Non-Asbestos? It's YOUR CHOICE!

Asbestos, or Non-Asbestos? It's YOUR choice!

“I urge you to take no action. One Word: CHOICE. This is America. My restaurant is nonsmoking. MY CHOICE. Mike Duffy allows smoking. HIS CHOICE.”

That’s what Roberto Trevino (Amigo’s Restaurant) said when speaking against the proposed smoke-free air proposal during the public portion at Kirkwood City Council meeting on Thursday evening, July 16, 2009.

Later, Kirkwood City Council members considered and voted on the initiative petition submitted by Healthy Air for Kirkwood or HAK, a local citizens group. It was introduced as Bill # 9992, amending Chapter 17 of the Code of Ordinances to add “Clean Air Act- Smoking Prohibited.”

[Please click here to view the proposed language.]

Just as in 2006, when local residents mobilized to submit an initiative petition in support of smoke-free air, after hearing public testimony, the council again voted it down unanimously on Thursday. That was no surprise. There is no leadership being provided by the council on this issue, and opponents are painting it as just a repeat of a past failed effort by unspecified “outsiders,” even though there’s no evidence to support that.

If we look at this historically, it used to be the Tobacco Industry that actively opposed smoke-free air efforts and was invariably viewed as the outsider, and supporters of local smoke-free air laws were able to galvanize support by exposing tobacco lobbyist’s involvement. How are smoke-free air opponents getting away with their absurd current tactic?

Even if the major voluntary health agencies, such as the American Cancer Society, American Lung Association, and American Heart Association, were actively involved, that would be perfectly legitimate for such organizations: Its consistent with their goals of protecting the public from the twin scourges of cancer and heart disease, both of which have been firmly identified as causally linked to active smoking and secondhand smoke exposure.

Missouri GASP is a grass roots group representing Missouri communities and with a legitimate interest in what happens in Kirkwood, since we have members and supporters living there, yet we’ve stayed out of this in recognition of HAK’s concern about being tarred with this “outsiders” brush!

What continues to mystify me is how dumb some elected officials and opponents are on this issue, repeating mindlessly some of the tobacco industry’s favorite arguments.

Those speaking during the public portion were evenly divided, as follows:

Pro (“Healthy Air for Kirkwood”): Reese Forbes, Tony Masi, Mary Murphy-Overmann
Other Pro: Steve Peterson, Ryan Lundy, Stacy Reliford, Michele McDonnell, Ed Tasch, Mike Prosperi, Doug Luke, PhD., Matt Wever, Kathy Paulsen – 11 total

Con: Gary Pederson, Alan Hopefl, Mike Duffy, Eric Jost, Linda Fenton, Roberto Trevino, John Dodson, Jr., Lloyd Sneeters, Joe Toenjes, Steve Sheridan, David Kuneman – 11 total

You could argue that one, Steve Peterson (VP Student Affairs-Meramec), was neutral but I would put him the smoke-free air camp. He reportedly said:

“The community colleges do not allow smoking on our campuses. In the Fall, Meramec will be smoke free, also the South County campus. The college smoking ban had student input.”

[mogasp: I’ve made copious use of notes taken by Alan Hopefl of the entire proceedings and then made available in the public domain. My thanks to him and to Reese Forbes for e-mailing them to me. Also my thanks to Joan Loemker and Nancy Wamble, who both attended, for additional information.]

First, some excerpts from public comments in favor of smoke-free air, mostly based on notes by someone present opposed to smoke-free air:

Reese Forbes (Kirkwood resident and member of HAK): Referring to ban opponents he said, “I’ve never heard such misinformation.” He claims that this ordinance is a new one and was written by Kirkwood people and lawyers.

Tony Masi, Healthy Air for Kirkwood: Claims it is possible to run a smoke-free restaurant. Claims second hand smoke is toxic like lead paint and asbestos. He hopes the Council will favor the health of citizens over profit.

Stacy Reliford (ACS employee currently on maternity leave): “It is the responsibility of the government to protect citizens.”

Michele McDonnell: “We think of this emotionally.” Claims there is a causal relationship between breast cancer and second hand smoke. Has anecdotes from NY City smoking ban.

Ed Tasch (Executive Director of the National Council on Alcohol and Drug Abuse – St. Louis): Claims a smoking ban is important. Bans send a message to children. “What’s the message the Council wants to send to our children?”

Mike Prosperi (IMO’s Pizza –Kirkwood): One of the few restaurants that are smoke free for the last two years who spoke in favor of the smoking ban.

Douglas A. Luke, PhD

Douglas A. Luke, PhD

Dr. Doug Luke, Professor at Washington Univ.: Supports the ban.

[mogasp: Douglas A. Luke, PhD., Adjunct Professor, Department of Community Health in Biostatistics, is a leading researcher in the St.Louis University School of Public Health. He’s also Director of Washington University’s Center for Tobacco Policy Research. I’m fortunate to know him personally through past Missouri GASP collaboration.]

Mary Murphy-Overmann: “Healthy Air for Kirkwood represents the 1200 persons from Kirkwood who signed the initiative petition to ban smoking in restaurants.”

Here are some comments by opponents:

Alan Hopefl: Commented that this proposed ordinance would take away the ability of business owners to choose how to run their restaurant and deprive patrons of the ability to choose where they want to eat. Also stated that there are no studies showing that banning smoking in restaurants/bars produces any health benefits. Studies on second-hand smoke are mostly done in households and cannot be extrapolated to bar/restaurants. Urges Council to vote against the initiative.

Mike Duffy, President of Kirkwood Restaurant Assn.: He has serious concerns about the effect this ban would have on his business. He requests the Council take no action on the initiative. He recommends a State-wide ban that would not harm us. Our customers vote with their money.

Eric Jost, Orchard Way: (owner Top Hat Tobacco): This issue came up several years ago. The tobacco industry is already over regulated. We need to consider that we are a business friendly community and we need to continue that. Please take no action on this.

Linda Fenton, N. Signal Hills: I oppose this bill. This proposal is from outsiders pushing their issue. Our elected leaders in 2006 said this should be a state-wide issue. Who is sponsoring this? This is not the same process Clayton used. An outside group is forcing this on Kirkwood.

John Dodson, Jr. Peeke Ave. I’m a pipe smoker and I am opposed to this for one reason. It upsets me that our rights are being taken away. Our Constitution gives us rights. This would take away a business owners rights. This ban is unconstitutional.

David Kuneman (Rock Hill, retired chemist and supporter of the on-line Smokers Club): Talked about economics and retail sales from states that have or don’t have smoking bans. He claims smoking bans hurt retail sales. In states with a ban 7% lower sales. Looking at the big picture, bans hurt businesses and will hurt business here.

During the debate by council members there were some noteworthy comments, according to sources who were present:

Kirkwood City Councilman, Iggy Yuan

Kirkwood City Councilman, Iggy Yuan

Councilman Iggy Yuan (at left): “Healthy Air for Kirkwood is like vultures circling and waiting for the right moment to pounce. We decided this a few years ago. It’s a matter of choice. My parents came to America for freedom. Channel your energies to the County or State on this issue.”
Kirkwood City Councilman, Timothy Griffin

Kirkwood City Councilman, Timothy Griffin

Councilman Timothy Griffin (who made an unsuccessful motion to delay action): Pronounced the proposed ordinance as “Wrong, wrong, wrong!” He stated: “I cannot understand why this should be passed. No one forces anyone to go into places where smoking is allowed. Tobacco is legal. Their efforts should be on making tobacco illegal. It’s not right to tell business owners how to run their business. I don’t care what Paris does, or what Ballwin does, or Clayton does.”
There was further discussion before the vote to pass the bill by Council Members Godi, Ward, Jaksetic, and Mayor McDonnell, who spoke of honoring the choice of the citizens via the initiative process and putting the matter on the ballot for them to decide.

[mogasp: In other words, instead of doing their duty to protect the public health and welfare from a clearly defined environmental hazard, they’re punting the ball. That certainly takes courage!]

Below is the on-line ST. LOUIS POST-DISPATCH story by reporter Phil Sutin. It generated a FLOOD of reader comments, 147 as of July 19, 2009 at 11:19AM CST, possibly more than any other recent smoking-related story:

Kirkwood to consider smoking ban tonight


The Kirkwood City Council has opted to let voters decide this fall whether to ban smoking in indoor public places.

After listening to speakers address the proposed ban for about an hour, the council voted 6-0 to reject an initiative brought by an anti-smoking group. The vote means the matter is now headed for the November ballot.

KIRKWOOD –- Opponents of a smoking ban in the city have submitted to officials a competing initiative proposal. Rather than prohibit smoking in indoor public places, it would require their operators to post signs saying whether smoking is permitted, restricted or forbidden.

The city council tonight will consider a smoking ban that an anti-smoking group put before it through a petition with 1,089 signatures. Supporters of the competing proposal have to collect 1,035 signatures on petitions to start the initiative process.

Choose Kirkwood, the promoter of the competing initiative, submitted its proposal to City Clerk Betty Montano late Tuesday afternoon. Officials asked the St. Louis County Election Board to check whether the 10 members of a committee sponsoring the initiative are Kirkwood voters, as the city charter requires.

Montano asked the sponsors to clarify the title of its initiative. She said it should make clear that the proposal involves the posting of signs relating to smoking.

Joe Toenjes, a leader of Choose Kirkwood, said his group, the anti-smoking group and the city council should have a dialog on the issue. He urged the anti-smoking group to withdraw its proposal.

Toenges said he would like to see the competing proposals on the same ballot if the anti-smoking initiative goes forward. He said his group could obtain the needed signatures on its proposal in a month.

If the council opposes the anti-smoking initiative, it may reject it tonight for procedural reasons. After a rejection, the council must pass a bill that would put the initiative on the November ballot. The council must vote on it at two separate meetings in August if it is meet the Aug. 25 deadline to put items on the November ballot. The council meets only twice more after tonight before the deadline.

[mogasp: The first vote is expected to be at the council meeting on August 6.]

Sponsors of the anti-smoking initiative and city officials want a vote in November. The officials have said the cost of the election would be less than one in February, the next available election date. St. Louis County has a proposal on the November ballot; Kirkwood would share the cost of that election. Kirkwood would have to pay the entire election cost in February.

With very few exceptions, the anti-smoking measure would allow smoking only in private homes, private vehicles and outdoors. Among exceptions are 20 percent of hotel and motel rooms designated smoking rooms, private clubs established before March 1 and retail tobacco stores.”

Clayton aldermen unanimously approve smoke-free air law

It’s official! On Tuesday, July 14, 2009, the mayor and aldermen of the City of Clayton unanimously approved an historic smoke-free air bill at its second and final reading. It won’t go into effect until July 1, 2010, for existing establishments (effective immediately for new businesses) but it’s very welcome news.

The mayor and aldermen looked at the evidence on secondhand smoke and whether there was any good alternative to smoke-free air, such as the air cleaners being aggressively promoted by Mr. Bill Hannegan. They rightly concluded that only a comprehensive smoke-free air law could provide the protection that citizens and employees need and businesses should provide.

By this action Clayton is reclaiming the leadership role it established when it became only the second municipality in metro St. Louis to enact a limited smoke-free air ordinance in 1988. That followed a successful effort by former Alderman (and later Mayor) Ben Uchitelle, who spent three years pursuing this goal.

This is not welcome news to those opposed to such laws, who have swallowed all the old arguments developed and used by the tobacco lobby over the years, and regurgitate them ad nauseam. Some of those arguments are in the on-line Comments section of the St. Louis Post-Dispatch immediately following the story on the vote by reporter Phil Sutin. [Please click here to view.]

Congratulations to all those who made this very important victory possible, Missouri GASP and its members among them!

Hannegan continues SHS deception

The on-line St. Louis Post-Dispatch permits readers to air their views by having a Comments section following every story. Mr. Bill Hannegan is a prolific poster to those sections. What concerns me is the reliability of his reference material.

When I first became involved in the SHS issue, as a scientist I felt compelled to give the tobacco industry the benefit of the doubt when they published any study or rebuttal in a newspaper ad. I quickly learned that their aim was not to further the truth about secondhand smoke but to obscure it, and create doubt on the subject.

Mr. Hannegan seems intent on following in their footsteps. A good example is his repeated reference to the controversial study Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98 by Enstrom & Kabat published in the British Medical Journal in 2003. Contrary to many other peer-reviewed studies this concluded that there is no causal relationship between SHS and coronary heart disease and lung cancer in exposed non-smokers.

In a previous blog American Heart Association and KEEP ST. LOUIS FREE! team up(?!) I noted both the American Cancer Society’s strong condemnation of the misuse of its data by Enstrom & Kabat, and the criticism from many scientists on the BMJ website, including one from Jayant S Vaidya, University College London, Dept of Surgery, titled Flawed study from the outset

Today’s Post-Dispatch has a story by reporter Margaret Gillerman on page B1 As Clayton goes no smoking, others might follow, some believe

Bill Hannegan was quick to post an on-line comment ( July 12, 2009 12:59AM CST) accusing Clayton’s mayor and aldermen of not giving “serious consideration to the air filtration systems that Clayton restaurateurs had installed to protect employees from tobacco smoke exposure, even though the Clayton aldermen knew that Surgeon General Carmona admitted in his report that such systems might adequately mitigate the risks of secondhand smoke in restaurants.”

This statement is simply untrue, as I verified by checking U.S. Surgeon General Dr. Richard H. Carmona’s most recent report on SHS: The Health Consequences of Involuntary Exposure to Tobacco Smoke, published in 2006. In his Preface to the report Dr. Carmona writes:

Restrictions on smoking can control exposures effectively, but technical approaches involving air cleaning or a greater exchange of indoor with outdoor air cannot.

Chapter 10 is devoted to the subject Control of Secondhand Smoke Exposure which draws the following conclusions on page 649 on how to provide protection from SHS, with the most relevant to this discussion bolded:

1. Workplace smoking restrictions are effective in reducing secondhand smoke exposure.
2. Workplace smoking restrictions lead to less smoking among covered workers.
3. Establishing smoke-free workplaces is the only effective way to ensure that secondhand smoke exposure does not occur in the workplace.
4. The majority of workers in the United States are now covered by smoke-free policies.
5. The extent to which workplaces are covered by smoke-free policies varies among worker groups, across states, and by sociodemographic factors. Workplaces related to the entertainment and hospitality industries have notably high potential for secondhand smoke exposure.
6. Evidence from peer-reviewed studies shows that smoke-free policies and regulations do not have an adverse economic impact on the hospitality industry.
7. Evidence suggests that exposure to secondhand smoke varies by ethnicity and gender.
8. In the United States, the home is now becoming the predominant location for exposure of children and adults to secondhand smoke.
9. Total bans on indoor smoking in hospitals, restaurants, bars, and offices substantially reduce secondhand smoke exposure, up to several orders of magnitude with incomplete compliance, and with full compliance, exposures are eliminated.
10. Exposures of nonsmokers to secondhand smoke cannot be controlled by air cleaning or mechanical air exchange.

Once again it’s very clear that opponents of smoke-free air don’t care how they bend or subvert the science. They are true disciples of the tobacco industry and its long history of denial and subversion of public health.

West County firefighters put out the (cigarette) smoke

Blythe Bernhard reported the story with the above headline in today’s (Saturday, Jul. 11, 2009) St. Louis Post-Dispatch and it garnered a number of comments from naysayers. A link noted by storywiz caught my eye, since he claimed it “debunked the whole nonsense about second hand smoke.” That must be some link, I thought!

The link at took me to a page on the web site Critical Thinking titled Rationality: Second Hand Smoke Myth, allegedly quoting directly from Sid Kirchheimer on WebMD Health News. It refers to the (heavily criticized) study published in the British Medical Journal in May 2003 by Enstrom and Kabat. [Please see my previous blog American Heart Association and KEEP ST. LOUIS FREE! team up(?!) for additional information on this study.]

The article heading and subheading are:

Second hand Smoke Study Raises Ire
Study Shows No Association Between Passive Smoke and Health Risks

The article apparently reproduced in its entirety on Critical Thinking seems pretty clear-cut:

“May 15, 2003 — A controversial new study that questions the health risks of being exposed to secondhand smoke — a factor often said to contribute to some 50,000 American deaths each year — has outraged some health officials.

The new study, to be published in the May 17 issue of the British Medical Journal, shows no measurable rates of heart disease or lung cancer among nonsmokers who ever lived with smokers, and reports only a slight increased risk of chronic obstructive pulmonary disease. Many health agencies, including the U.S. Surgeon General’s Office, have long said that secondhand smoke boosts the risk of heart disease by about 30% and lung cancer risk by 25% in nonsmokers.

“We found no measurable effect from being exposed to secondhand smoke and an increased risk of heart disease or lung cancer in nonsmokers — not at any time or at any level,” lead researcher James Enstrom, PhD, MPH, of the UCLA School of Public Health, tells WebMD.

Since Sid Kirchheimer of WebMD seems to be a reputable source I found this article attributed to him surprising and did a search to find the original. I found it published on-line here. When you read Kirchheimer’s entire article he paints a completely different picture, starting with the full subheading in which I’ve bolded what Critical Thinking just happened to omit:

Study Shows No Association Between Passive Smoke and Health Risks; Others Criticize Research

The first three paragraphs above posted on Critical Thinking omit the two paragraphs immediately following on WebMD:

However, the American Cancer Society blasted the study — and Enstrom — for misusing its own data in an attempt to “confuse the public about the dangers of secondhand smoke.” And former U.S. Surgeon General Julius Richmond, MD, is expected to join other medical experts in calling the study “bogus” in a news conference on Friday.

The study was funded in part by the Center for Indoor Air Research, which the American Cancer Society says is an arm of Philip Morris and other tobacco companies. Enstrom requested and received funding for the study in 1997.

The last paragraph on the Critical Thinking web page would also lead one to believe there’s little if any evidence of health problems caused by secondhand smoke exposure:

In fact, researchers reported in the Journal of the American Medical Association in 1998 that 75% of studies done between 1980 and 1995 found no link between secondhand smoke and health problems.

However, read the WebMD article and the above paragraph is followed by this comment, again omitted by Critical Thinking:

“While this study is flawed, there are at least 50 very reputable studies that find a link between secondhand smoke and lung cancer and at least 50 others that find an increased risk of heart disease,” says Thun. (1)

(1) Michael Thun, MD, head of epidemiological research, American Cancer Society.

So once again we find selective information posted on the web which paints a completely false picture of the evidence linking secondhand smoke with disease in exposed nonsmokers, and which is then referenced in a comment following a Post-Dispatch story on West County firefighters being required to go smoke-free.

The tobacco industry may not appear to be actively involved in the “debate” anymore but there seem to be plenty of eager surrogates out there willing to take its place.