User:John Quiggin/Passive smoking draft

Tobacco industry response

The scientific community had reached consensus on passive smoking as a cause of disease by the mid-1980's, and industry documents show that tobacco companies had determined even earlier that passive smoking was harmful to non-smokers.^{, p. 1525} Nonetheless, controversy over the harms of passive smoking has persisted, generated and sustained in large part by the tobacco industry.

Individual studies and criticism of epidemiology

A number of studies funded by the tobacco industry have yielded results inconsistent with the scientific consensus, or have criticised aspects of the epidemiological approach associated with that consensus.

A 2003 study by Enstrom and Kabat, published in the British Medical Journal, argued that the harms of passive smoking had been overstated. Their analysis reported no relationship between passive smoking and lung cancer; they did find that passive smoking increased the risk of chronic obstructive pulmonary disease, although Enstrom and Kabat downplayed this finding in their article. This paper was promoted by the tobacco industry as evidence that the harms of passive smoking were unproven.^{, p. 1383}Enstrom and Kabat's findings were strongly criticized, both on methodological grounds and because the authors were funded by the tobacco industry.

Gio Batta Gori, a full-time tobacco-industry consultant, wrote in the libertarian Cato Institute's journal Regulation that "...of the 75 published studies of ETS and lung cancer, some 70 percent did not report statistically significant differences of risk and are moot. Roughly 17 percent claim an increased risk and 13 percent imply a reduction of risk." Steven Milloy, the "junk science" commentator for Fox News and a former Philip Morris consultant, claimed that "...of the 37 studies [on passive smoking], only 7 – less than 19 percent – reported statistically significant increases in lung cancer incidence."

Another component of criticism promoted by Milloy focused on relative risk and epidemiological practices in studies of passive smoking. Milloy argued that studies yielding relative risks of less than 2 were meaningless junk science. This approach to epidemiological analysis was criticized in the American Journal of Public Health:

A major component of the industry attack was the mounting of a campaign to establish a "bar" for "sound science" that could not be fully met by most individual investigations, leaving studies that did not meet the criteria to be dismissed as "junk science."

World Health Organization controversy

A 1998 report by the International Agency for Research on Cancer (IARC) on environmental tobacco smoke (ETS) found "weak evidence of a dose-response relationship between risk of lung cancer and exposure to spousal and workplace ETS." In March of 1998, before the study was published, reports appeared in the media alleging that the IARC and the World Health Organization (WHO) were suppressing information. The reports, appearing in the British Sunday Telegraph and The Economist, among other sources, alleged that the WHO withheld from publication its own report that supposedly failed to prove an association between passive smoking and a number of other diseases (lung cancer in particular).

In response, the WHO issued a press release stating that the results of the study had been "completely misrepresented" in the popular press and were in fact very much in line with similar studies demonstrating the harms of passive smoking. The study was published in the Journal of the National Cancer Institute in October of the same year. An accompanying editorial summarized:

When all the evidence, including the important new data reported in this issue of the Journal, is assessed, the inescapable scientific conclusion is that ETS is a low-level lung carcinogen.

With the release of formerly classified tobacco industry documents through the Tobacco Master Settlement Agreement, it was found that the controversy over the WHO's alleged suppression of data had been engineered by Philip Morris, British American Tobacco, and other tobacco companies in an effort to discredit scientific findings which would harm their business interests. A WHO inquiry, conducted after the release of the tobacco-industry documents, found that this controversy was generated by the tobacco industry as part of its larger campaign to cut the WHO's budget, distort the results of scientific studies on passive smoking, and discredit the WHO as an institution. This campaign was carried out using a network of ostensibly independent front organizations and international and scientific experts with hidden financial ties to the industry.

The Osteen decision

In 1993, the United States Environmental Protection Agency (EPA) issued a report estimating that 3,000 lung cancer related deaths in the U.S. were caused by passive smoking annually. Philip Morris, R.J. Reynolds Tobacco Company, and groups representing growers, distributors and marketers of tobacco took legal action, claiming that the EPA had manipulated this study and ignored accepted scientific and statistical practices.

United States District Court Judge William Osteen ruled in favor of the tobacco industry in 1998, finding that the EPA had failed to follow proper scientific and epidemiologic practices and had committed to their conclusions in advance. In 2002, the EPA successfully appealed Judge Osteen's decision to the United States Court of Appeals for the Fourth Circuit. The EPA's appeal was upheld on the preliminary grounds that their report had no regulatory weight, and Osteen's decision was vacated.

Tobacco-industry funding of research

The tobacco industry's role in funding scientific research which "exonerates" passive smoking has been controversial, although a focus on the funding source of studies has been criticized as ad hominem. Tobacco-industry funding has been shown to have a real effect on research findings: a literature review found that the only factor associated with concluding that passive smoking is not harmful was whether an author was affiliated with the tobacco industry. In a specific example which came to light with the release of tobacco-industry documents, Philip Morris executives successfully encouraged an author to revise his industry-funded review article to downplay the role of secondhand smoke in sudden infant death syndrome. The 2006 U.S. Surgeon General's report criticized the tobacco industry's role in the scientific debate:

The industry has funded or carried out research that has been judged to be biased, supported scientists to generate letters to editors that criticized research publications, attempted to undermine the findings of key studies, assisted in establishing a scientific society with a journal, and attempted to sustain controversy even as the scientific community reached consensus.

This strategy was outlined at an international meeting of tobacco companies in 1988, at which Philip Morris proposed to set up a team of scientists, organized by company lawyers, to "carry out work on ETS to keep the controversy alive." All scientific research was subject to oversight and "filtering" by tobacco-industry lawyers:

Philip Morris then expect the group of scientists to operate within the confines of decisions taken by PM scientists to determine the general direction of research, which apparently would then be 'filtered' by lawyers to eliminate areas of sensitivity.

Philip Morris reported that it was putting "...vast amounts of funding into these projects... in attempting to coordinate and pay so many scientists on an international basis to keep the ETS controversy alive."

Current state of controversy

Comment: I have deleted this section, but would favour incorporating it in the main body of the article