A prep course for the month-long World Cup soccer tournament, a worldwide pheno
Download 9.93 Mb. Pdf ko'rish
|
has placed a controversial initiative on the November ballot that would undo loc al ordinances designed to curb secondhand smoke and replace them with a looser s tandard . ( Begin optional trim ) And cigarette maker R.J. Reynolds has launched an aggressive public information campaign designed to stave off smoking bans by countering the widespread perception that secondhand smoke is dangerous . The c ompany 's tactic : Fight science with science . In full-page newspaper ads , R.J . Reynolds says its research shows that nonsmokers are exposed to `` very little '' secondhand smoke , even when they live or work with smokers . In one month , the company said , a nonsmoker living with a smoker would breathe the equivalen t of smoking 1 cigarettes . ( End optional trim ) `` Policies should be based on science , '' Chris Coggins , the R.J. Reynolds toxicologist , said in an interv iew last week . `` I think that the ( EPA ) science is very , very weak . '' But the industry has a long way to go toward rolling back public policy on secondha nd smoke . More than 600 state and local ordinances restrict smoking in public p laces . Across the United States , in cities large and small , a familiar sight has emerged : Smokers congregating outside . The federal Occupational Health and Safety Administration is contemplating a ban in all workplaces . This month , a congressional subcommittee approved a bill , introduced by Rep. Henry A . Waxma n , D-Calif. , that would ban smoking in most buildings , except restaurants and private clubs . There is no smoking on domestic flights . There is no smoking i n the White House ; first lady Hillary Rodham Clinton will not tolerate it . The re is no smoking with your Big Mac ; McDonald 's recently banned tobacco in its corporate-owned restaurants . Taco Bell and Jack in the Box followed suit . Last year , the U.S. Supreme Court ruled in favor of a Nevada prisoner who called hi s cellmate 's smoke cruel and unusual punishment . Custody battles have been set tled by giving preference to parents who do not smoke . The turnabout from a smo king to a smoke-free society seems to have occurred overnight . It could not hav e happened , anti-smoking advocates say , without science . `` Twenty years ago , I tried to have one room in a cruise ship declared smoke-free and I was told I was crazy , '' said John Banzhaf , a law professor at George Washington Univers ity who runs Action on Smoking and Health , or ASH . `` Who at that time would h ave figured that 30 percent of all our businesses would be smoke-free today ? .. . Things are moving amazingly quickly , and it is the scientific , medical unde rpinning that has changed the complexion of the issue . '' Today , several hundr ed scientific studies link secondhand smoke to a variety of diseases : lung and other cancers , heart disease , respiratory infections including bronchitis and pneumonia , asthma and sudden infant death syndrome , or SIDS , which claims the lives of babies as they sleep . This research is responsible for an oft-quoted statistic : About 53,000 Americans die each year from secondhand smoke . `` The evidence is so clear , '' says Mark Pertschuk , co-director of Americans for Non -Smokers Rights . `` Everybody and his brother is lining up to ban smoking . '' Yet the evidence , while compelling , is not as complete as Pertschuk suggests . Of each year 's secondhand-smoke deaths , 3,000 are attributed to lung cancer , 12,000 to other cancers and 37,000 to heart disease , according to the Coalitio n on Smoking OR Health , a nonprofit group formed by the American Lung Associati on , the American Heart Association and the American Cancer Society . The coalit ion also estimates that secondhand smoke accounts for 700 SIDS deaths a year . M ost scientists working outside the tobacco industry say the link between lung ca ncer and secondhand smoke is firmly established . But the evidence on heart dise ase which accounts for nearly 70 percent of estimated deaths is much newer , and not all scientists accept it . Only 14 studies have documented this link , and the federal government has not yet taken a position . Nonetheless , public toler ance for secondhand smoke is waning . A recent Gallup Poll showed 38 percent of Americans support a ban on smoking in restaurants up 10 percent from three years ago . Support for workplace smoking bans is at 32 percent , up eight points fro m 1991 . The poll also found 36 percent of Americans believe secondhand smoke is very harmful to adults , and 42 percent believe it is somewhat harmful . `` The tide has turned , '' says Michael Eriksen , director of the Office on Smoking a nd Health at the U.S. . Centers for Disease Control and Prevention . `` I think an invisible line was crossed in terms of how the public feels about smoking . ' ' The tobacco industry is trying its best to persuade people to cross back over that line . The vast majority of the research on secondhand smoke is epidemiolog ical , meaning it traces patterns of disease and finds connections , rather than proving cause and effect . Based on those studies , scientists are just beginni ng to conduct animal research to learn the precise biological effects of secondh and smoke . Tobacco industry officials vehemently dispute the epidemiology , inc luding the EPA report . They say some study subjects give inaccurate information about how much smoke they have been exposed to , or whether they have ever smok ed . R.J. Reynolds officials also cite a recent report by the Congressional Rese arch Service the research branch of the Library of Congress that characterized t he EPA 's data as `` uncertain . '' Coggins , the Reynolds toxicologist , compla ins that the EPA failed to include recent data that found no link between lung c ancer and secondhand smoke . `` The epidemiological evidence is not sufficient t o say that ( secondhand smoke ) poses a health risk , '' says Gio Batta Gori , a toxicologist and consultant for the Tobacco Institute , a trade industry group . Next : An Unwilling Fighter in the War on Secondhand Smoke SAN FRANCISCO Rosita Garcia never wanted to be a poster girl for the fight agai nst tobacco . But here she is , living testimony in the debate over the dangers of second-hand smoke : the cocktail waitress who never touched a cigarette but g ot lung cancer after 11 years of serving drinks in the blue haze of a smoky airp ort bar . This is not how she wants to be remembered . At 39 , she is a very pri vate woman , a former fitness buff ( she quit exercising when the cancer was dis covered ) who hates to be thought of as being sick . She does not look sick ; th ere is color in her cheeks , her dark eyes are bright , her waistline is full a sign that she is again eating well . Yet the evidence is there , if one looks cl ose enough . She wears her reddish-brown hair in a pixie cut , not by design but by necessity it is just growing back after chemotherapy and radiation . With ev ery few sentences , she lets out a sputtering cough . Lately , she says , her ch est has been hurting . Sometimes , she must excuse herself to vomit . The coldes t proof of all sits in the medical file that Garcia keeps in the closet of her t iny government-subsidized apartment in Daly City , a working-class suburb just s outh of San Francisco . Although her disease , diagnosed nearly three years ago , is confined to a single lung and is not getting worse , neither is it getting better . Her tumors , reduced to scar tissue by radiation , may recur . Her onco logist says she is lucky to have survived . Her prognosis : Fair . Garcia 's pli ght provides a snapshot of the human side of the emotional secondhand smoke deba te . Last year , the U.S. . Environmental Protection Agency declared secondhand smoke a human carcinogen , saying that it causes 3,000 lung cancer deaths a year . Health advocacy groups put the annual total death toll at 53,000 from secondh and smoke , including deaths from various forms of cancer , as well as from hear t disease . Despite these figures and several hundred scientific studies documen ting the ill effects of secondhand smoke , the tobacco industry counters with re search showing that it is little more than a nuisance . As a consequence , Garci a and others who count themselves as its victims must battle not only disease , but also skeptics . For Garcia , the fight comes with a price tag : $ 26,889 . T hat is the cost of her medical care . She is seeking this amount , plus her week ly wages , in a workers ' compensation suit that is languishing in the bureaucra cy while she lives on disability checks of $ 600 a month . Her former employer , Host Marriott , which operates the bars where Garcia worked for more than a dec ade , thus far has successfully fought the claim , saying Garcia did not get sic k at work . At the San Francisco airport , a handful of Garcia 's former colleag ues have waged a losing battle to clean the barroom air . Ironically , the airpo rt has won plaudits for its aggressive anti-smoking policy ; in 1991 , it became the first airport in the nation to ban tobacco in all public places with one no table exception : bars . For the next two years there was nowhere else for smoke rs to go . Then in 1993 , the airport began installing ventilated smoking rooms . Although airport officials could have banned tobacco in the bars , they left t hat decision to Host Marriott , which after a trial ban chose to let smoking con tinue . The reason ? Economics. Bars lose money when patrons cannot smoke . Cust omers complained . Tips got so low that even the bartenders many of whom say the smoke makes them sick asked to have smoking back . `` No smoking did not go ove r well , '' said Nancy Wood , a Host Marriott official . `` We had a very hard t ime explaining to our client base , which is largely international travelers , w hy they couldn't smoke in the bar . '' The struggle at the San Francisco airport typifies a nationwide wrestling match over the issue of secondhand smoke . Whil e more workplaces are banning tobacco use , in restaurants , bars and other quar ters , matters of health collide with matters of money . Money often wins . More over , what is sufficient proof for the medical establishment may not be good en ough in a courtroom , as Garcia 's faltering workplace injury claim shows . The case , which is hung up on a technicality , pits the word of a noted researcher who says Garcia 's lung cancer was caused by secondhand smoke against the word o f a Host Marriott doctor , who says it was not . ( Begin optional trim ) Nationw ide , there have been dozens of lawsuits and workers ' compensation cases filed by victims of secondhand smoke , including a recent $ 650 million wrongful death suit filed against tobacco manufacturers by the heirs of a Mississippi barber . The risk of a nonsmoker getting lung cancer is 1 in 250 , far lower than the 1- in-8 risk for a smoker , according to Lawrence Garfinkel , a consultant to the A merican Cancer Society . And of all diseases that may be caused by secondhand sm oke , the link to lung cancer is most firmly established . But , Garfinkel notes , `` any one case is hard to prove . '' ( End optional trim ) The key question for Garcia , in the cumbersome language of state bureaucrats , is whether her di sability is `` the result of occupation , either as an industrial accident or as an occupational disease . '' The answer ? Yes , said Dr. Christine Angeles , th e Kaiser Permanente physician who first treated Garcia . Angeles based her concl usion on Garcia 's account that she had been exposed to excessive secondhand smo ke at work . No , said Dr. Irene Danse , who was hired by Host Marriott lawyers to examine Garcia . Noting that Garcia is Filipino , Danse wrote in her report t hat Asian women , `` for some reason that has not been defined , '' seem prone t o lung cancer . Citing a study that found Garcia 's workplace exposure to be equ ivalent to smoking one cigarette per day , Danse concluded : `` I cannot link he r lung cancer to her job . '' To counter that assertion , Garcia 's lawyer hired Stanton A . Glantz , professor of medicine at University of California , San Fr ancisco , and one of the nation 's most respected researchers on the issue of se condhand smoke . Glantz reviewed Garcia 's medical records . He found that she h ad only incidental exposure to secondhand smoke at home , that she had no exposu re to other toxic agents such as asbestos or radon that might have caused her ca ncer . He dismissed the study Danse cited as flawed and said she had ignored `` large and compelling scientific literature . '' Garcia 's cancer , he concluded , was caused `` in major part , by her exposure to environmental tobacco smoke a t her place of employment . '' But there was a problem with Glantz 's report . H e is a Ph.D. , not a medical doctor , and he never examined Garcia . So Host Mar riott persuaded a workers ' compensation judge to strike his testimony . The jud ge also ruled that it was too late for Garcia to be examined by a medical doctor . That was in March 1993 , and the question of whether Glantz will be permitted to testify has lingered on appeal . Without Glantz , Garcia 's lawyer says , he has no case . ( Optional Add End ) Tom McBirnie , a staff attorney for the Work ers ' Compensation Board , suspects that Garcia 's claim has been delayed in par t because workers ' compensation law is not equipped to deal with the emerging s cience of secondhand smoke . `` What we basically see , '' McBirnie said , `` ar e bad backs and stress claims . '' NEXT : How Dangerous Is Secondhand Smoke ? DAVIS , Calif. . The big brown building , a short walk off a country road in th is scenic college town , looks more like a barn than a high-tech university labo ratory . Inside , a rare and curious contraption is engaged in a habit that the surgeon general warns is bad for your health . This is Kent Pinkerton 's creatio n : the University of California , Davis , smoking machine . As an associate pro fessor of anatomy at Davis , Pinkerton is interested in how the lungs work . His specialty has landed him at the crossroads of politics and medicine . In his la b at the university 's Institute of Toxicology and Environmental Health , Pinker ton and his colleagues hope their unusual smoking machine will inject hard scien ce into the roiling national debate over the dangers of secondhand smoke . How , they are eager to know , are the cells and tissues of the lungs altered by expo sure to secondhand smoke ? Are infants born smaller when they are exposed in the womb ? Does secondhand smoke induce changes in the nasal passageways that lead to asthma ? Is there a precise dose for lack of a better term at which it become s dangerous ? If so , where does the threshold lie ? The government has classifi ed secondhand smoke as a human carcinogen and nonsmokers worry that the slightes t whiff of smoke could wreak havoc on their lungs and hearts . Cigarette compani es are waging a counterattack , insisting that it is little more than a nuisance . The truth , which independent scientists say is somewhere in between , may em erge from the smoking machine . Scientific truths about secondhand smoke are not easy to come by . Studies are difficult and expensive to conduct , and funding is limited . Moreover , ethical considerations prevent researchers from subjecti ng humans to cigarette smoke , at least not for days on end . Nor can they ask p eople to smoke for the sake of science . Hence the busy Davis smoking machine . Five days a week , six hours a day , the machine is at work , blowing smoke at g uinea pigs and hamsters , whose body parts will later be dissected in an effort to identify biological reactions that may be similar in humans . The device one of just two large-scale smoking machines in the nation outside of those owned by tobacco companies smokes more precisely than any person ever could , and therei n lies its value . There are no Marlboros , Camels or Virginia Slims here . Rath er , the smoking machine 's brand of choice is one few people have heard of the 1R4F . These low-tar and nicotine research cigarettes , each manufactured from t he same tobacco blend , are produced by the University of Kentucky . They were r olled in 1983 and kept in a deep freeze until being shipped to Davis , where the y are conditioned for up to 48 hours at 70 percent humidity before being smoked . Every 10 minutes , a steel piston fires another 1R4F into a revolving cylinder . A small metal coil , the sort used to heat an ordinary blow-dryer , lights th e cigarette with a tiny red glow . As ashes begin to emerge , two others are in various stages of being smoked . The whole mechanism is encased in a plexiglass box that is yellow with smoke residue . Through a series of pipes , the box is c onnected to chambers where the animals are kept . With every puff , the cylinder clicks another revolution and a red light flashes . Each cigarette there are ne ver more than three burning at any time is smoked in precisely the same fashion : one puff a minute , each puff lasting two seconds , eight puffs in all . To cr eate each puff , a vacuum draws in 35 milliliters of air no more , no less . The re is , Pinkerton says , an important reason for all this precision . Soft-spoke n and lanky , the scientist is a master of understatement , never going out on a limb . `` If we are going to understand the mechanisms ( by which secondhand sm oke injures people ) , '' he says , `` we need to have well-controlled condition s . '' The Davis studies have been under way for three years a short span in sci ence , when research often lasts for decades . The university scientists are par ticularly interested in the effects of secondhand smoke on young children ; stud ies show infants and toddlers who may suffer from bronchitis , asthma and other respiratory diseases when exposed to secondhand smoke in the home are its primar y victims . Among the Davis findings : Toxicologist Peter Witschi has shown that pregnant rats exposed to secondhand smoke gave birth to pups that weighed 6 per cent less than those born to other rats not a dramatic reduction , but one that experts say is significant . Dr. Jesse Joad , a pediatrician , has demonstrated that newborn rats exposed to secondhand smoke in the womb and after birth test p ositive for asthma . Pinkerton has found that the lungs of newborn rats develop more slowly when exposed to secondhand smoke . As part of the experiments , Joad is investigating how nerve fibers in the lungs of guinea pigs are harmed by exp osure to secondhand smoke ; the damage prevents the lungs from fending off other pollutants . Witschi is trying to determine whether a particularly strong carci nogen called NNK produces lung tumors in hamsters exposed to secondhand smoke , as it does in animals that breathe direct smoke . Few such studies have been don e before . `` This is very beginning stuff , '' Joad said , adding : `` The kind of testing that we are going to do absolutely could never be done on children . '' Tobacco industry critics contend that the research is a waste of time . Chri s Coggins , a toxicologist for R.J. Reynolds , says he has done his own animal r esearch on rats and found no biological changes in the heart , lungs or respirat ory system . The only damage documented in the study which appeared last year in the journal Inhalation Toxicology occurred in the tip of the rats ' noses , Cog gins said , and was `` completely reversible '' when they were no longer exposed to the smoke . Tobacco industry consultant Gio Batta Gori , also a toxicologist , calls the Davis studies irrelevant . Humans , Gori argues , have the `` intri nsic capacity '' to clear their bodies of low-level pollutants , including secon dhand smoke . `` You can manipulate the experiments any way you want and come up with some results , '' Gori complained of the research at Davis and other anima l studies . `` You can choose a strain ( of animal ) that is susceptible , and y ou can use doses that are beyond the capacity of the animals to clear . '' Witsc hi says the doses can be manipulated and must be if scientists are to learn at w hat levels secondhand smoke becomes dangerous . ( Optional add end ) On these ex periments hang the answers to crucial questions about secondhand smoke 's health effects . According to the U.S. . Centers for Disease Control and Prevention , as well as health advocacy groups , 53,000 people die each year from exposure to secondhand smoke . This figure is based on epidemiology studies , which examine patterns of illness but do not prove cause and effect . The studies implicate s econdhand smoke in lung cancer and other cancers , heart disease , sudden infant death syndrome , bronchitis , pneumonia and asthma , especially in children . T he U.S. . Environmental Protection Agency , relying on the lung cancer epidemiol ogy , has declared secondhand smoke a Group A human carcinogen a classification that puts it in the same category as radon and asbestos . But tobacco industry o fficials say the EPA 's research is flawed because people overestimate the amoun t of smoke they have been exposed to , or lie about their smoking habits . The a nimal research may settle this debate by showing what epidemiology cannot : prec isely how secondhand smoke wreaks its havoc , and exactly how much exposure is d angerous . As it turns out , the major problem with my childhood was that I wasn't paying attention to the right things . Kids , learn from my experience . That 's what I 'm here for . What you should be doing is watching TV . Much more TV . Forget w hat everybody says about TV ruining the lives of young people . It was not watch ing enough TV that ruined mine . Believe me , I could be a rich man today if , a s a kid , I had taken the time to watch `` The Flintstones . '' As you may have heard , it is now a movie . Not just a movie it did $ 37.5 million at the box of Download 9.93 Mb. Do'stlaringiz bilan baham: |
ma'muriyatiga murojaat qiling