The Tobacco Industry's Secondhand Smoke Cover-Up

Many of the tobacco industry's underhanded strategies and tactics have been exposed, thanks to landmark legal cases and the hard work of public health advocates. But we are still uncovering the shocking lengths to which the industry has gone to protect itself from public-health measures like smoking bans. Now we can thank the city of Pueblo, Colo., for an opportunity to look a little bit deeper into how the industry managed the deadly deceptions around secondhand smoke.

A new study, the ninth of its type and the most comprehensive one yet, has shown a major reduction in hospital admissions for heart attacks after a smoke-free law was put into effect.

On July 1, 2003, the relatively isolated city of Pueblo enacted an ordinance that prohibited smoking in workplaces and indoor public areas, including bars and restaurants. For the study, researchers reviewed hospital admissions for heart attacks among area residents for one year prior to, and three years after the ban, and compared the data to two nearby areas that didn't have bans (the part of Pueblo County outside city limits, and El Paso County, which includes Colorado Springs). Researchers found that during the three years after the ban, hospital admissions for heart attacks dropped 41 percent inside the city of Pueblo, but found no significant change in admissions for heart attacks in the two control areas.

The eight previous studies in other locales used similar techniques and yielded similar results, but covered shorter periods of time -- usually about one year after the smoking ban went into effect. The results of this longer, more comprehensive study support the view that not only does secondhand smoke have a significant short-term impact on heart function, but that lives, and money, are probably being saved by new laws proliferating around the world in recent years that minimize public exposure to secondhand smoke.

Tobacco Smoke and the Heart

When most people think "cigarette smoke," they immediately think "lung cancer," but far less public attention has been paid to how secondhand smoke effects heart function. In a memo dated 1980 that I discovered in 1999, a Philip Morris scientist points out that nicotine lowers the heart's threshold to ventricular fibrillation -- an inefficient heart-pumping pattern -- which increases people's susceptibility to heart attacks.

A 1991 report sponsored by the Environmental Protection Agency estimated that secondhand smoke kills 53,000 Americans year, mostly from heart disease. A public health study published in 2001 showed that exposure to secondhand smoke for even short periods of time, as little as 30 minutes, causes changes in blood platelets and cardiac epithelium. Lung cancer takes many years to develop, but heart function is affected more rapidly upon exposure to secondhand smoke.

Tobacco Companies Have Long Been Aware of Secondhand Smoke Hazards

Tobacco companies knew much more about the health hazards of secondhand smoke, and knew it longer ago, than most people realize.

Recognizing the need to do more biological research on its own products, but also understanding the need to distance itself from this research for legal reasons, in 1971 Philip Morris purchased a biological lab in Germany called Institut Fur Biologische Forschung (INBIFO), or Institute for Biological Research. Philip Morris then created a complex routing system to ensure that work done at INBIFO could not be linked back to the company. INBIFO routed its study results through a Philip Morris research-and-development facility in Switzerland called Fabriques de Tabac Reunies, and documents created at INBIFO were often in French or German language.

Between 1981 and 1989, Philip Morris conducted at least 115 inhalation studies on secondhand smoke at INBIFO in which it compared the toxicity of mainstream smoke (what the smoker inhales) to that of secondhand smoke. Philip Morris discovered that secondhand smoke is two to six times more toxic and carcinogenic per gram than mainstream smoke. The company never published the results of these in-house studies or alerted public health authorities to the findings. Rather, it kept this information strictly to itself -- even most Philip Morris employees were unaware of these studies.