The report may be downloaded in toto or in four sections. The printed version, released in December, 1986 by Surgeon General C. Everett Koop, M.D., has 359 pages. After its release Dr. Koop was vilified mercilessly by the tobacco industry who argued it was not science, but merely part of his anti-tobacco agenda.
Estimates of annual U.S. lung cancer deaths among nonsmokers resulting from exposure to secondhand smoke were still the subject of investigation, and ranged up to over 5,000 each year in a study by Repace, as I recall. The number finally accepted was 3,000 lung cancer deaths per year subsequent to publication of this report, the major conclusions of which are pasted below.
After careful examination of the available evidence, the following overall conclusions can be reached:
1. Involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers.
2. The children of parents who smoke, compared with the children of nonsmoking parents, have an increased frequency of respiratory infections, increased respiratory symptoms, and slightly smaller rates of increase in lung function as the lung matures.
3. Simple separation of smokers and nonsmokers within the same air space may reduce, but does not eliminate, exposure of nonsmokers to environmental tobacco smoke.
The Report was accompanied by a press conference and press release by Dr. Koop on December 16 in Washington, D.C. The following is from a publication Human Resources Management, Issue No. 134, January 9, 1987, which had an article on the report and also reproduced his public remarks in full:
Dr. Koop, at the release of the 5th report on smoking prepared under his direction as Surgeon General, said the nation should now move decisively toward two objectives –
* First, the protection of nonsmokers from environmental smoke; and
* Second, helping smokers break the addiction that keeps them smoking.
The remarks of the Surgeon General concluded:
The National Academy of Sciences panel, in issuing their Report on passive smoking last month, estimated that ETS [or SHS] is responsible for approximately 2,400 lung cancer deaths annually. This compares to between 1,300 and 1,700 new cancer cases (all sites) resulting from toxic air pollutants in the general environment.
Therefore, for involuntary smoking and lung cancer: We know ETS contains carcinogens; the exposure to ETS by nonsmokers is large enough to expect a lung cancer risk; and human epidemiologic studies have demonstrated an increased risk of lung cancer in involuntary smokers. If this evidence were available on an environmental pollutant other than ETS, we would have acted long ago. To fail to act now on the evidence we currently have would be to fail in our responsibility to protect the public health.
The 50 largest metropolitan areas in the country, including St. Louis, were urged to implement recommendations for protecting nonsmokers. That failed to happen in the metro St. Louis area on any large scale but modest efforts by some municipalities did start as a result of this report.
The first smoke-free air ordinance in metro St. Louis, introduced by Alderman Leonard LaBerta, went into effect in the small St. Louis County township of Rock Hill in June 1987.
That was followed the next year by a more significant ordinance in Clayton, the seat of St. Louis County Government. It was the result of a three year persistent effort by Alderman Ben Uchitelle and went into effect on October 9, 1988.
Both of those ordinances had many loopholes, e.g. bars were exempted and restaurants had minimal restrictions, if any. It took another twenty years for comprehensive ordinances with very few exemptions to be approved: Ballwin (Sec. 17-65. Ballwin Clean Air Act: enacted 2005; fully effective January, 2006) and Clayton (enacted July 2009, effective date July 1, 2010).