ASHRAE Standard 62: tobacco industry's influence over national ventilation standards

Emerging Indoor Air Laws for Onsite Cannabis Consumption Businesses in the U.S

INTRODUCTION

Secondhand cannabis smoke, like secondhand tobacco smoke, creates unhealthy indoor air quality. Ventilation and engineering techniques cannot reduce this pollution to healthy levels, and complete smoke-free policies are the only way to provide healthy indoor environments. Even so, multiple state and local governments have begun to allow indoor smoking of cannabis in businesses.

METHODS

A systematic search of Lexis Advance, NewsBank, and government websites for U.S. state and local laws passed between November 6, 2012 and June 10, 2020 that permit and regulate onsite cannabis consumption businesses was conducted in February-July 2020.

RESULTS

In total, 6 of 11 states and the District of Columbia that legalized adult-use cannabis as of June 10, 2020 allowed onsite consumption and ≥56 localities within these 6 states allowed onsite cannabis consumption. Only 9% (5/56) of localities ban indoor smoking in these businesses; 23% (13/56) require indoor smoking to occur in physically isolated rooms. Other common local legal requirements address onsite odor control, ventilation/filtration, and building location.

CONCLUSIONS

The majority of the localities that allow onsite cannabis consumption do not explicitly prohibit smoking or vaping inside. Policymakers should be made aware that ventilation and other engineering interventions cannot fully protect workers and patrons. Health authorities and local leaders should educate policymakers on the science of secondhand smoke remediation and advocate for the same standards for secondhand cannabis smoking and vaping that apply to tobacco, particularly because other modes of cannabis administration do not pollute the air.

Hiding in the Shadows: Philip Morris and the Use of Third Parties to Oppose Ingredient Disclosure Regulations

Background

In 1996 Massachusetts proposed regulations that would require tobacco companies to disclose information about the ingredients in their products on a by-brand basis. This paper examines the strategies employed by Philip Morris to stop these regulations from being implemented.

Methods and Finding

We used previously secret tobacco industry documents and published literature to examine the activities of the tobacco companies after the regulations were proposed. Philip Morris hired a public relations firm to establish a coalition that was instructed to oppose the regulations by linking them to other industrial sectors (the slippery slope) and stating they would damage the state's economy. Philip Morris also retained a polling firm to test the popularity of specific arguments against ingredient disclosure and developed a strategic plan for opposing similar regulations in Vermont.

Conclusion

Tobacco companies have historically used third parties to form coalitions to oppose ingredient disclosure regulations. These coalitions have had success preventing regulations from being implemented after they are initially proposed by creating the appearance of local opposition. With countries around the world currently implementing ingredient disclosure regulations in the WHO Framework Convention on Tobacco, governments and regulatory agencies should be aware of the political strategies that the tobacco companies have used to create the impression of popular opposition to these measures.

Harnessing the public health power of model codes to increase drinking water access in schools and childcare

Drinking water is an important health behavior to support overall child health. Research indicates that children are consuming too little water and too many sugary drinks. Overconsumption of sugary drinks increases child risk for the epidemics of obesity and diet-related chronic diseases like type-II diabetes, stroke, and heart disease. Increasing access to appealing, low-cost drinking water in schools and childcare where children spend much of their time supports efforts to reduce sugary drink consumption. Drinking water infrastructure is key to water access in childcare and schools. In 2012-2013, almost one-third of permanent U.S. school buildings had plumbing systems in fair or poor condition, and almost 40 percent had major renovations or repairs planned.3 Basic plumbing standards for new construction and major renovations or repairs are contained in state and local plumbing codes, and many of these codes are derived from model codes established by private organizations. This article describes the model code process and intervention points where the public health community can work to improve plumbing standards in school buildings and childcare centers.

Indoor air quality in a bar/restaurant before and after the smoking ban in Athens, Greece

In this study we compared indoor air pollutant concentrations in a bar/restaurant in Greece before and after the enactment of a smoking ban legislation of 2008. This was done to investigate whether the separation of the venue into smoking and non-smoking areas will have an impact on workers and customers from secondhand smoke (SHS) exposure (null hypothesis). The study was completed within an 8-month period beginning in March 2010 and ending on November 2010. We compared the average of the measured PM0.1 concentrations in the smoking zones between the pre-ban and post-ban periods. Overall reduction in the number of particles was 18% between pre-ban and post-ban periods. The mean of the 36 total CO2 measurements for the pre- and the post-ban period was 611ppm. We calculated the ventilation rates per occupant (Vo in l/s/occ) and found it to be higher in the post-ban period (19.4l/s/occ), thus complying with the ASHARAE standard for Vo of 15l/s/occ at maximum occupancy, than in the pre-ban period (10.7l/s/occ). The mean of the 36 total CO measurements for the pre-ban period was 2 ppm. CO measurements in the post-ban period were less than the detection limit of 1 ppm. Emissions of nitrogen dioxide and formaldehyde weren't detected in any of the zones. It was observed there was about 50% distribution of pollutants from the smoking zones to the smoke-free zones. The smoking ban effect on the occupancy levels was initially reduced by 16%, but based on other similar studies this transition period will be followed by an increase in the occupancy. Passive smoking and associated risks were significantly reduced but not totally eliminated, indicating the need for stronger enforcement or complete partition between smoking and non-smoking areas.

Protecting the world from secondhand tobacco smoke exposure: where do we stand and where do we go from here?

INTRODUCTION

Article 8 of the Framework Convention on Tobacco Control mandates all signatory countries to "protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places." Even though there has been great progress in the implementation of Article 8, still most of the world population remains exposed to secondhand smoke (SHS). In this article, we sought to summarize the research that supports Article 8, where do we stand, and current research gaps and future directions.

DISCUSSION

Secondhand smoke is an established cause of heart disease and several types of cancer. Additional research is needed to reach final conclusions for diseases where evidence is only suggestive of causality. The only solution to SHS exposure in public places is banning smoking indoors. Research on the gaming industry and nightclubs, particularly in developing countries, needs to be disseminated to support their inclusion in smoke-free laws. Aside from indoor bans, additional research is needed for outdoor and multiunit housing bans and in support of measures that protect children and other vulnerable populations. The impact of smoke-free laws on other health outcomes, besides heart disease and respiratory outcomes, is another area where further research is needed. Thirdhand smoke assessment and health effects are also likely to be a topic of further research. As new tobacco products emerge, evaluating SHS exposure and effects will be vital.

CONCLUSIONS

Furthering research in support of Article 8 can contribute to reach the final goal of protecting everyone from SHS exposure.

Failure of policy regarding smoke-free bars in the Netherlands

BACKGROUND

Tobacco companies consistently work to prevent and undermine smoke-free laws. The tobacco industry and its allies have funded hospitality associations and other third parties to oppose smoke-free laws, argue that smoke-free laws will economically damage hospitality venues, promote ventilation and voluntary smoker 'accommodation' as an alternative to smoke-free laws, and to challenge smoke-free laws in court. In 2008, the Netherlands extended its smoke-free law to hospitality venues.

METHODS

We triangulated news articles, government documents, scientific papers, statistical reports and interviews to construct this case study.

RESULTS

Despite widespread public support for smoke-free hospitality venues, opponents successfully represented these laws as unpopular and damaging to small bars. These challenges and related smokers' rights activities resulted in non-compliance among all bars and reinstating an exemption for small, owner-run venues. This policy reversal was the result of a weak implementing media campaign (which failed to present the law as protecting nonsmokers), smoking room exemptions and reactive (vs. proactive) measures by the Ministry of Health and civil society.

CONCLUSION

The policy failure in the Netherlands is the result of poor implementation efforts and the failure to anticipate and deal with opposition to the law. When implementing smoke-free laws it is important to anticipate opposition, used the media to target non-smokers to reinforce public support, and actively enforce the law.

Through tobacco industry eyes: civil society and the FCTC process from Philip Morris and British American Tobacco's perspectives

OBJECTIVE

To analyse the models Philip Morris (PM) and British American Tobacco (BAT) used internally to understand tobacco control non-governmental organizations (NGOs) and their relationship to the global tobacco control policy-making process that resulted in the Framework Convention for Tobacco Control (FCTC).

METHODS

Analysis of internal tobacco industry documents in the Legacy Tobacco Document Library.

RESULTS

PM contracted with Mongoven, Biscoe, and Duchin, Inc. (MBD, a consulting firm specialising in NGO surveillance) as advisors. MBD argued that because NGOs are increasingly linked to epistemic communities, NGOs could insert themselves into the global policy-making process and influence the discourse surrounding the treaty-making process. MBD advised PM to insert itself into the policy-making process, mimicking NGO behaviour. BAT's Consumer and Regulatory Affairs (CORA) department argued that global regulation emerged from the perception (by NGOs and governments) that the industry could not regulate itself, leading to BAT advocating social alignment and self-regulation to minimise the impact of the FCTC. Most efforts to block or redirect the FCTC failed.

CONCLUSIONS

PM and BAT articulated a global policy-making environment in which NGOs are key, non-state stakeholders, and as a result, internationalised some of their previous national-level strategies. After both companies failed to prevent the FCTC, their strategies began to align. Multinational corporations have continued to successfully employ some of the strategies outlined in this paper at the local and national level while being formally excluded from ongoing FCTC negotiations at the global level.

The politics of smoking in federal buildings: an executive order case study

Executive orders are important presidential tools for health policymaking that are subject to less public scrutiny than are legislation and regulatory rulemaking. President Bill Clinton banned smoking in federal government buildings by executive order in 1997, after the administration of George H. W. Bush had twice considered and abandoned a similar policy. The 1991 and 1993 Bush proposals drew objections from agency heads and labor unions, many coordinated by the tobacco industry. We analyzed internal tobacco industry documents and found that the industry engaged in extensive executive branch lobbying and other political activity surrounding the Clinton smoking ban. Whereas some level of stakeholder politics might have been expected, this policy also featured jockeying among various agencies and the participation of organized labor.

Tobacco industry efforts undermining evidence linking secondhand smoke with cardiovascular disease

BACKGROUND

The scientific consensus that secondhand smoke (SHS) increases cardiovascular disease (CVD) risk by 30% is based on epidemiological and biological evidence. The tobacco industry has contested this evidence that SHS causes CVD, but how and why they have done it has not been described.

METHODS AND RESULTS

About 50 million pages of tobacco industry documents were searched using general keywords and names of industry consultants and scientists. Tobacco industry-funded epidemiological analyses of large data sets were used to argue against an epidemiological association between SHS and CVD and smoke-free regulations, but these analyses all suffered from exposure misclassification problems that biased the results toward the null. More recent industry-funded publications report an increased risk of CVD associated with SHS but claim a low magnitude of risk. When early tobacco industry-funded work demonstrated that SHS increased atherosclerosis, the industry criticized the findings and withdrew funding. RJ Reynolds focused on attacking the biological plausibility of the association between SHS and CVD by conducting indirect platelet aggregation studies, exposure chamber experiments, and literature reviews. Although these studies also suffered from exposure misclassification problems, several produced results that were consistent with a direct effect of SHS on blood and vascular function. Instead, RJ Reynolds attributed these results to an unproven epinephrine-related stress response from odor or large smoke exposure, which supported their regulatory and "reduced-harm" product development efforts. Philip Morris' recent "reduced-harm" efforts seem supportive of a similar corporate agenda.

CONCLUSIONS

The tobacco industry attempted to undermine the evidence that SHS causes CVD to fight smoke-free regulations while developing approaches to support new products that claim to reduce harm. The industry interest in preserving corporate viability has affected the design and interpretation of their cardiovascular studies, indicating the need for great caution in current debates about future tobacco industry regulation and development of reduced-harm tobacco products.

Philip Morris's Project Sunrise: weakening tobacco control by working with it

OBJECTIVE

To analyse the implications of Philip Morris USA's (PM's) overtures toward tobacco control and other public health organisations, 1995-2006.

DATA SOURCES

Internal PM documents made available through multi-state US attorneys general lawsuits and other cases, and newspaper sources.

METHODS

Documents were retrieved from several industry documents websites and analysed using a case study approach.

RESULTS

PM's Project Sunrise, initiated in 1995 and proposed to continue through 2006, was a long-term plan to address tobacco industry delegitimisation and ensure the social acceptability of smoking and of the company itself. Project Sunrise laid out an explicit divide-and-conquer strategy against the tobacco control movement, proposing the establishment of relationships with PM-identified "moderate" tobacco control individuals and organisations and the marginalisation of others. PM planned to use "carefully orchestrated efforts" to exploit existing differences of opinion within tobacco control, weakening its opponents by working with them. PM also planned to thwart tobacco industry delegitimisation by repositioning itself as "responsible". We present evidence that these plans were implemented.

CONCLUSION

Sunrise exposes differences within the tobacco control movement that should be further discussed. The goal should not be consensus, but a better understanding of tensions within the movement. As the successes of the last 25 years embolden advocates to think beyond passage of the next clean indoor air policy or funding of the next cessation programme, movement philosophical differences may become more important. If tobacco control advocates are not ready to address them, Project Sunrise suggests that Philip Morris is ready to exploit them.

The tobacco industry's role in the 16 Cities Study of secondhand tobacco smoke: do the data support the stated conclusions?

BACKGROUND

Since 1996, the tobacco industry has used the 16 Cities Study conclusions that workplace secondhand tobacco smoke (SHS) exposures are lower than home exposures to argue that workplace and other smoking restrictions are unnecessary.

OBJECTIVES

Our goal was to determine the origins and objectives of the 16 Cities Study through analysis of internal tobacco industry documents and regulatory agency and court records, and to evaluate the validity of the study's conclusions.

RESULTS

The tobacco industry's purpose in conducting the 16 Cities Study was to develop data showing that workplace SHS exposures were negligible, using these data to stop smoking restrictions by the U.S. Occupational Safety and Health Administration. The extensive involvement of R.J. Reynolds Tobacco Company and the tobacco industry's Center for Indoor Air Research in controlling the study was not fully disclosed. The study's definition of "smoking workplace" included workplaces where smoking was restricted to designated areas or where no smoking was observed. This definition substantially reduced the study's reported average SHS concentrations in "smoking workplaces" because SHS levels in unrestricted smoking workplaces are much greater than in workplaces with designated smoking areas or where no smoking occurred. Stratifying the data by home smoking status and comparing exposures by workplace smoking status, however, indicates that smoke-free workplaces would halve the total SHS exposure of those living with smokers and virtually eliminate SHS exposure for most others.

CONCLUSIONS

Data in the 16 Cities Study reveal that smoke-free workplaces would dramatically reduce total SHS exposure, providing significant worker and public health benefits.

Avoiding "truth": tobacco industry promotion of life skills training

PURPOSE

To understand why and how two tobacco companies have been promoting the Life Skills Training program (LST), a school-based drug prevention program recommended by the Centers for Disease Control and Prevention to reduce youth smoking.

METHODS

We analyzed internal tobacco industry documents available online as of October 2005. Initial searches were conducted using the keywords "life skills training," "LST," and "positive youth development."

RESULTS

Tobacco industry documents reveal that since 1999, Philip Morris (PM) and Brown and Williamson (B&W) have worked to promote LST and to disseminate the LST program into schools across the country. As part of their effort, the companies hired a public relations firm to promote LST and a separate firm to evaluate the program. The evaluation conducted for the two companies did not show that LST was effective at reducing smoking after the first or second year of implementing the program. Even so, the tobacco companies continued to award grants to schools for the program. PM and B&W's role in promoting LST is part of a public relations strategy to shift the "youth smoking paradigm" away from programs that highlight the tobacco industry's behavior and toward programs in which the industry can be a partner.

CONCLUSIONS

Individuals and organizations responsible for developing and implementing tobacco control and youth smoking prevention programs should be aware of PM and B&W's role and motivations to encourage the wide-spread adoption of LST in schools.

Courtesy and the challenges of implementing smoke-free policies in Japan

For decades, the tobacco companies have developed a worldwide campaign to oppose the creation of smoke-free environments. Public health efforts to promote clean indoor air have been uneven throughout the world, and in few places have such efforts faced as many challenges as in Japan. The Japanese market is dominated by Japan Tobacco, which is partly owned by the government, and Philip Morris International is also present in Japan. Japan Tobacco and Philip Morris International have developed campaigns promoting courtesy and tolerance that, until recently, seem to have resonated well with the public. The companies also have supported research promoting ventilation and have funded consultants to act as experts in the area of second-hand smoke exposure. Japan is a critical country to study, partly because of the strength of Japan Tobacco in the country and the growth of Japan Tobacco International in Southeast Asia and the rest of the world, and partly because of Japan's ratification of the World Health Organization Framework Convention on Tobacco Control. This paper uses tobacco industry documents to provide an overview of the tobacco industry's scientific and political efforts to stifle the development of clean indoor measures in Japan. Learning past industry strategies may assist policymakers and advocates in the development of future public health activities.

Nursing's involvement in tobacco control: historical perspective and vision for the future

There is little evidence that nursing organizations have played a major leadership role in addressing tobacco control at the political level, and none have addressed collectively, in any sustained way, the role of the tobacco industry, the primary vector of the tobacco disease epidemic. The aims of this article are (a) to explore what accounts for organized nursing's relative quiescence about tobacco industry and (b) to elucidate why a nursing voice would be especially effective in addressing the industry as a vector of the tobacco disease epidemic. Drawing on the internal tobacco industry documents research, and incorporating a critical theoretical perspective on education, research, and practice, it is argued that tobacco cessation cannot be viewed solely as an individual problem but must be understood in a sociopolitical context and promoting a nursing agendum on cessation research and practice requires educating (and energizing) nurses on the sociopolitics of tobacco. Because of nurses' numbers, class status, political capital, and moral authority in society, they are the group of health professionals whose voices are needed urgently at this historical moment to help avert the global tobacco epidemic. The Nightingales is an example of a nursing group involved in activism against the tobacco industry, applying findings from research on the industry to engage nurses in tobacco control activism, research, and education. The cessation research agenda should include research on the tobacco industry and how its activities influence cessation, how political activism influences cessation, and how critical education may advance cessation research, policies, and practices.

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.

The tobacco industry's worldwide ETS consultants project: European and Asian components

BACKGROUND

The tobacco industry has formed regional environmental tobacco smoke (ETS) consultants programs in order to generate controversy on the issue of secondhand smoke (SHS) in Europe, Asia and Latin America. Only those countries in which the industry foresaw SHS restrictions were included. This paper describes the European and Asian components of the tobacco industry's worldwide ETS consultants program.

METHODS

A systematic search was carried out of tobacco industry documents available on the Internet between October 2002 and February 2004.

RESULTS

Beginning in 1987, Philip Morris assembled an international ETS consultants program in collaboration with other tobacco companies based on their market shares in different regions of the world. The law firm Covington & Burling contacted and hired consultants with a wide range of expertise, usually affiliated with an academic institution, in order to avoid direct contact with the industry. The objective of the program was to influence policy makers, media and the public by providing, through their consultants, 'accurate' (pro-industry) information concerning smoking regulations in public places and workplaces, indoor air quality and ventilation standards, and scientific claims regarding SHS. Consultants also conducted research related to SHS and organized and attended regional and international symposiums related to SHS without acknowledging industry funding.

CONCLUSIONS

Despite evidence that the issue of smoke-free environments was close to emerging within the general public throughout the world in the late 1980s, the tobacco industry used its well-organized network of consultants to avoid SHS regulations in most of the world.

Hedging their bets: tobacco and gambling industries work against smoke-free policies

OBJECTIVE

To describe and understand the relationship between the tobacco and gambling industries in connection to their collaborative efforts to prevent smoke-free casinos and gambling facilities and fight smoke-free policies generally.

METHODS

Analysis of tobacco industry documents available online (accessed between February and December 2003).

RESULTS

The tobacco industry has worked to convince the gambling industry to fight against smoke-free environments. Representatives of the gambling industry with ties to the tobacco industry oppose smoke-free workplaces by claiming that smoke-free environments hurt gambling revenue and by promoting ventilation as a solution to secondhand smoke. With help from the tobacco industry, the gambling industry has become a force at the American Society of Heating Refrigeration and Air Conditioning Engineers opposing smoke-free ventilation standards for the hospitality industry.

CONCLUSION

Tobacco industry strategies to mobilise the gambling industry to oppose smoke-free environments are consistent with past strategies to co-opt the hospitality industry and with strategies to influence policy from behind the scenes. Tobacco control advocates need to be aware of the connections between the tobacco and gambling industries in relation to smoke-free environments and work to expose them to the public and to policy makers.

The Living Tomorrow Project: how Philip Morris has used a Belgian tourist attraction to promote ventilation approaches to the control of second hand smoke

STUDY OBJECTIVE

To examine the involvement of Philip Morris in Living Tomorrow 2 and determine the rationale behind its involvement.

DESIGN

Research was conducted through a web based search of internal tobacco industry documents made publicly available through litigation.

MAIN RESULTS

For approximately 1,000,000 euros Philip Morris (now Altria) became a co-initiator of Living Tomorrow 2, a tourist complex in Belgium that aims to demonstrate how we will be living in the future. In addition to promoting the company and its grocery products, Philip Morris is using the complex and its website to promote ventilation as a means of accommodating smokers and non-smokers in the indoor environment. Particular emphasis was placed on the bar and restaurant areas. Despite the rationale for its involvement, Philip Morris fails to acknowledge its role as a cigarette manufacturer. As a form of corporate sponsorship Philip Morris thought its involvement could evade any European tobacco advertising ban.

CONCLUSIONS

Philip Morris is using a tourist attraction to promote its views on control of second hand smoke (SHS) and accommodation of smokers and non-smokers in the indoor environment. However, ventilation does not deal with the health effects of SHS. Policymakers must be cognisant of the devious tactics the industry employs to promote its own agenda, especially in relation to indoor air quality and smoking in public places. Tobacco control legislation should be continually modified and strengthened in response to the changing activities of the tobacco industry as it strives to evade existing legislation and deter the advent of new legislation.

ARTIST (Asian regional tobacco industry scientist team): Philip Morris' attempt to exert a scientific and regulatory agenda on Asia

OBJECTIVE

To describe how the transnational tobacco industry has collaborated with local Asian tobacco monopolies and companies to promote a scientific and regulatory agenda.

METHODS

Analysis of previously secret tobacco industry documents.

RESULTS

Transnational tobacco companies began aggressively entering the Asia market in the 1980s, and the current tobacco industry in Asia is a mix of transnational and local monopolies or private companies. Tobacco industry documents demonstrate that, in 1996, Philip Morris led an organisation of scientific representatives from different tobacco companies called the Asian Regional Tobacco Industry Science Team (ARTIST), whose membership grew to include monopolies from Korea, China, Thailand, and Taiwan and a company from Indonesia. ARTIST was initially a vehicle for PM's strategies against anticipated calls for global smoke-free areas from a World Health Organization secondhand smoke study. ARTIST evolved through 2001 into a forum to present scientific and regulatory issues faced primarily by Philip Morris and other transnational tobacco companies. Philip Morris' goal for the organisation became to reach the external scientific and public health community and regulators in Asia.

CONCLUSION

The Asian tobacco industry has changed from an environment of invasion by transnational tobacco companies to an environment of participation with Philip Morris' initiated activities. With this participation, tobacco control efforts in Asia face new challenges as Philip Morris promotes and integrates its scientific and regulatory agenda into the local Asian tobacco industry. As the local Asian tobacco monopolies and companies can have direct links with their governments, future implementation of effective tobacco control may be at odds with national priorities.

Tobacco industry efforts to present ventilation as an alternative to smoke-free environments in North America

OBJECTIVE

To describe how the tobacco industry developed a network of consultants to promote ventilation as a "solution" to secondhand smoke (SHS) in the USA.

METHODS

Analysis of previously secret tobacco industry documents.

RESULTS

As with its other strategies to undermine the passage of clean indoor legislation and regulations, the tobacco industry used consultants who represented themselves as independent but who were promoting the industry's ventilation "solution" strategies under close, but generally undisclosed, industry supervision. The nature of the industry's use of ventilation consultants evolved over time. In the 1980s, the industry used them in an effort to steer the concerns about indoor air quality away from secondhand smoke, saying SHS was an insignificant component of a much larger problem of indoor air quality and inadequate ventilation. By the 1990s, the industry and its consultants were maintaining that adequate ventilation could easily accommodate "moderate smoking". The consultants carried the ventilation message to businesses, particularly the hospitality business, and to local and national and international regulatory and legislative bodies.

CONCLUSION

While the tobacco industry and its consultants have gone to considerable lengths to promote the tobacco industry's ventilation "solution", this strategy has had limited success in the USA, probably because, in the end, it is simpler, cheaper, and healthier to end smoking. Tobacco control advocates need to continue to educate policymakers about this fact, particularly in regions where this strategy has been more effective.

A tobacco industry study of airline cabin air quality: dropping inconvenient findings

OBJECTIVE

To examine an industry funded and controlled study of in flight air quality (IFAQ).

METHODS

Systematic search of internal tobacco industry documents available on the internet and at the British American Tobacco Guildford Depository.

RESULTS

Individuals from several tobacco industry companies, led by Philip Morris, designed, funded, conducted, and controlled the presentation of results of a study of IFAQ for the Scandinavian airline SAS in 1988 while attempting to minimise the appearance of industry control. Industry lawyers and scientists deleted results unfavourable to the industry's position from the study before delivering it to the airline. The published version of the study further downplayed the results, particularly with regard to respirable suspended particulates. The study ignored the health implications of the results and instead promoted the industry position that ventilation could solve problems posed by secondhand smoke.

CONCLUSIONS

Sponsoring IFAQ studies was one of several tactics the tobacco industry employed in attempts to reverse or delay implementation of in-flight smoking restrictions. As a result, airline patrons and employees, particularly flight attendants, continued to be exposed to pollution from secondhand smoke, especially particulates, which the industry's own consultants had noted exceeded international standards. This case adds to the growing body of evidence that scientific studies associated with the tobacco industry cannot be taken at face value.

Turning free speech into corporate speech: Philip Morris' efforts to influence U.S. and European journalists regarding the U.S. EPA report on secondhand smoke

BACKGROUND

Previously secret internal tobacco company documents show that the tobacco industry launched an extensive multifaceted effort to influence the scientific debate about the harmful effects of secondhand smoke. Integral to the industry's campaign was an effort to derail the Environmental Protection Agency's (EPA) risk assessment on environmental tobacco smoke (ETS) by recruiting a network of journalists to generate news articles supporting the industry's position and pushing its public relations messages regarding the ETS issue.

METHODS

Searches of previously secret internal tobacco industry records were conducted online and at the Minnesota Tobacco Document Depository. In addition, searches on the World Wide Web were conducted for each National Journalism Center alumnus. Lexis-Nexis was used to locate news stories written by the journalists cited in this paper.

RESULTS

Philip Morris turned to its public relations firm Burson Marsteller to "build considerable reasonable doubt em leader particularly among consumers" about the "scientific weaknesses" of the EPA report. A Washington, DC, media and political consultant Richard Hines was a key player in carrying out Burson Marsteller's media recommendations of "EPA bashing" for Philip Morris. In March 1993, Philip Morris' vice president of corporate affairs policy and administration reported to Steve Parrish, vice president and general counsel of Philip Morris, that their consultant was "responsible for a number of articles that have appeared in em leader major news publications regarding EPA and ETS." In addition to placing favorable stories in the press through its consultant, Philip Morris sought to expand its journalist network by financially supporting a U.S. school of journalism; the National Journalism Center (NJC). Philip Morris gleaned "about 15 years worth of journalists at print and visual media throughout the country em leader to get across [its] side of the story" resulting in "numerous pieces consistent with our point of view." The company planned to "design innovative strategies to communicate [its] position on ETS through education programs targeting policy makers and the media" via the NJC. Finally, journalists associated with think tanks that were financially supported by Philip Morris wrote numerous articles critical of the EPA.

CONCLUSIONS

This is the first report, from the tobacco industry's own documents, to show the extent to which the tobacco industry has gone to influence the print media on the issue of the health effects of secondhand smoke. Unfortunately, what we report here is that even journalists can fall victim to well-orchestrated and presented public relations efforts regardless of their scientific validity. It is not clear how various professional media organizations oversee the ethical conduct of their members. Certainly, on the topic of the health effects of secondhand smoke, more scrutiny is warranted from these organizations for articles written by their members lest the public be misinformed and thus ill served.

ASHRAE Standard 62: tobacco industry's influence over national ventilation standards

OBJECTIVE

To describe the role of the tobacco industry in the development of ventilation standards for indoor air quality by influencing the American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE).

METHODS

Review of tobacco industry documents available on the internet between January 2001 and March 2002. Search terms included "ASHRAE", "ventilation", "minutes", "memo", and the names of key players and organisations as identified in the initial searches. Analysis of ASHRAE and other relevant documents publicly available and the personal files of a Standard 62 committee member; interviews of a selected number of ASHRAE players; observation of an ASHRAE meeting.

RESULTS

The tobacco industry has been involved in the development of ventilation standards for over 20 years. It has successfully influenced the standard and continues to attempt to change the standard from a smoke-free framework into an "accommodation" framework. The industry acts directly and through consultants and allies. The major health groups have been largely absent and the health interests have been poorly represented in standard development. While concentrated in the USA, ASHRAE standards are adopted worldwide.

CONCLUSION

The tobacco industry determined that allowing smoking in ventilation standards for indoor air quality was a high priority and dedicated significant human and financial resources to ensure that its interests were represented. The health groups, until recently, have largely ignored the policy implications for tobacco control of standard development. This situation is changing, but unless health groups maintain high visibility within ASHRAE, the tobacco industry may succeed in creating a standard that ignores the dangers of secondhand smoke.