PASSIVE SMOKE IS MORE THAN A NUISANCE

WHAT constitutes a nuisance? A stalled car on the 520 bridge is a nuisance.
The neighbor's dog barking in the middle of the night is a nuisance.
Breathing someone else's smoke? That's much more than a nuisance, despite
The Seattle Times' editorial opinion on the matter ("Having second thoughts
about secondhand smoke," July 22). On July 17, a federal judge in North
Carolina struck down the 1993 EPA report classifying secondhand smoke as a
class A carcinogen. U.S. District Judge William Osteen took issue with the
EPA's statistical methods, and with the agency's exclusion of tobacco
industry representatives from its deliberations.

An executive from R.J. Reynolds claimed vindication and said, "The court's
ruling supports Reynolds Tobacco's long-held belief that science does not
justify public smoking bans."

EPA Administrator Carol Browner called the judge's ruling "disturbing." She
stood by the agency's findings, saying, "We believe the health threats to
children and adults are very real."

In its editorial, The Seattle Times declared, "in a world where truth in
science matters, believing is not enough."

As physicians and researchers, we agree with the Times - to a point.
Believing is not enough, and truth in science does matter. And the
scientific truth is this: Passive smoke is much more than a nuisance; it is
a well-documented, serious health threat to both children and adults.

The EPA is standing by its findings, and the weight of the scientific
evidence stands behind them as well. In the five years since the EPA report
was issued, evidence has continued to accumulate, clearly demonstrating
that secondhand smoke can cause or exacerbate serious health problems.

- -- A May 1998 literature review published in The Journal of the American
Medical Association evaluated more than 100 major studies regarding the
health effects of passive smoking. The reviewers concluded that a majority
(63 percent) found evidence of harm, ranging from acute and recurrent
respiratory problems to cancer. The same reviewers also discovered that
three-quarters of the reports that were inconclusive or found no health
effects were written by scientists affiliated with the tobacco industry.

- -- A recent California EPA report confirmed the findings of EPA's risk
assessment. The California report also linked secondhand smoke to cervical
cancer, as well as an increase in sudden infant death syndrome (SIDS).

The judge's ruling focused on EPA's use of the statistical procedure
"meta-analysis" to make its lung cancer risk assessment. Meta-analysis is a
common, well-established statistical methodology, useful for examining
multiple similar studies when a data trend is not immediately apparent. It
is an objective tool that provides a means of including both positive and
negative study results in the analysis.

The nature of secondhand smoke exposure makes its impact difficult to
quantify, but its negative effects are not in doubt. A single focus on the
link between secondhand smoke and lung cancer is shortsighted and
irresponsible. Solid, irrefutable evidence connects passive smoke with a
host of serious health effects, especially in children.

It is worth noting that the portions of the EPA risk assessment concerning
secondhand smoke and children's health remain unchallenged, even by the
tobacco industry. With regard to children, the EPA report found that:

- -- Children up to 18 months of age are at twice the risk of lower
respiratory tract infections such as bronchitis and pneumonia if their
parents smoke. The EPA estimated 150,000 to 300,000 cases annually in
infants and young children up to 18 months of age are attributable to
environmental tobacco smoke, resulting in 7,500 to 15,000 hospitalizations.

- -- Exposure to secondhand smoke is associated with increased prevalence of
fluid in the middle ear, symptoms of upper respiratory tract infection and
a small but significant reduction in lung function.

- -- Environmental tobacco smoke exposure has been linked to an increase in
both prevalence and severity of childhood asthma.

The overwhelming and growing body of evidence serves to indict
environmental tobacco smoke as a serious health hazard, despite the ruling
of one North Carolina judge.

But flush with its legal victory, the tobacco industry is claiming that the
ruling should "prevent the EPA from becoming a participant in the
anti-smoking industry's crusade to ban smoking," and that the decision
should serve to overturn bans on smoking in public places. Such an argument
flies in the face of not only science but also public sentiment.

The public reached its own conclusions about secondhand smoke years ago.
Average citizens didn't need research to tell them that breathing other
people's smoke made their eyes sting, their throats scratch, their lungs
ache, their heads throb and their clothes smell.

Science clearly corroborates what the public knows intuitively: Secondhand
smoke is dangerous to one's health. Using single studies or court rulings
to argue the point does not change this fact.

Drs. Gregory J. Redding (Children's Hospital and Regional Medical Center)
and Leonard D. Hudson (UW and Harborview Medical Center) are members of the
board of directors of the American Lung Association of Washington.

Checked-by: (Joel W. Johnson)