The Tobacco Industry's Role in the 16 Cities Study of Secondhand Tobacco Smoke: Do the Data Support the Stated Conclusions?
Barnes, Richard L., Hammond, S. Katharine, Glantz, Stanton A., Environmental Health Perspectives
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.
KEY WORDS: 16 Cities Study, Center for Indoor Air Research, environmental tobacco smoke, ETS, Occupational Safety and Health Administration, OSHA, R.J. Reynolds Tobacco Co., Roger Jenkins, secondhand tobacco smoke, SHS, smoke-free homes, smoke-free workplaces. Environ Health Perspect 114:1890-1897 (2006). doi: 10.1289/ehp.9385 available via http://dx.doi.org/ [Online 29 August 2006]
The tobacco industry has a history of manipulating science regarding both active and passive smoking to serve its political, legal, and regulatory needs (Barnes and Bero 1998; Barnoya and Glantz 2002, 2005; Bero 2005b; Bero et al. 1994; Glantz et al. 1996; Hirschhorn and Bialous 2001; Hong and Bero 2002; Muggli et al. 2001; Ong and Glantz 2001). Public concern about the health effects of secondhand smoke (SHS) increased sharply in 1981 when Hirayama (1981) linked SHS to lung cancer in non-smokers, followed by the 1986 Surgeon General's Report, The Health Consequences of Involuntary Smoking [U.S. Department of Health and Human Services (DHHS) 1986] and National Research Council (NRC) reports on SHS (NRC 1986b) and airliner cabin air quality (NRC 1986a). Just as it did when confronted with evidence in the 1960s that smoking caused lung cancer in smokers (Bero et al. 1995; Glantz et al. 1996), the tobacco industry responded with research designed to "establish a controversy" about the evidence linking SHS with disease (Barnes and Bero 1996, 1997, 1998; Barnes et al. 1995; Barnoya and Glantz 2002, 2005; Bero 2003, 2005b; Bero et al. 1994, 2001, 2005; Hirschhorn and Bialous 2001; Hong and Bero 2002; Muggli et al. 2001; Ong and Glantz 2001; Schotland and Bero 2002). This effort included industry personnel designing and supervising studies that undermined the connection between SHS and lung cancer (Lee 1995) and contested the conclusion that there were substantial levels of toxicants in airliners where smoking was allowed (Malmfors et al. 1989). Both these reports were published under the names of nonindustry authors and minimized unfavorable (to the tobacco industry) results (Hong and Bero 2002; Neilsen and Glantz 2003; Yano 2005).
In 1988, in response to a citizen petition seeking a standard prohibiting smoking in indoor workplaces (Public Citizen 1987), the U. …