Examination of Witnesses (Questions 140-159)
DR STEVE
STOTESBURY, MS
CHRISTINE MOHRMANN
AND MR
BARRY JENNER
20 OCTOBER 2005
Q140 Dr Naysmith: You must be aware
of the history of direct smoking and inhaling tobacco over the
years. People have denied, your industry has denied, that it had
any effect, and then there was an accumulation of evidence and
an accumulation of evidence until it is now impossible for anyone
to maintain that smoking tobacco does not cause a variety of diseases.
Do you not think the same thing is going to apply to inhaling
second-hand smoke?
Dr Stotesbury: No.
Q141 Dr Naysmith: Is that not the
most likely outcome of the current observations? Would it be right
that you are trying to hold the tide back?
Dr Stotesbury: No, I do not think
so. In fact, I think some of the most recent studies have been
the most convincing in terms of throwing some doubt over the relationship
between ETS and various diseases. I would point particularly to
a study that was published in the British Medical Journal just
two years ago by Enstrom and Kabat, which was a major study of
over 120,000 Californians over a 40-year period. The authors found
that the association between ETS, lung cancer and heart disease
was considerably weaker than generally believed.
Q142 Dr Naysmith: They did not find
that it did not exist. They may have suggested that it was weaker
than had previously been suggested.
Dr Stotesbury: They found absolutely
no difference between groups exposed to environmental tobacco
smoke and control groups. There was absolutely no difference at
all.
Q143 Dr Stoate: You have made some
very strong statements. You say there is no statistical link between
these diseases and environmental tobacco smoke, but there is extremely
strong evidence in children, for example, of cot death, glue ear,
respiratory diseases that can be very closely linked to cotinine
levels in families, and this is very compelling evidence. For
you to say there is no statistical evidence I think is misleading.
Dr Stotesbury: I do not think
I said there is no statistical evidence.
Q144 Dr Stoate: You did say that.
Dr Stotesbury: No. I said the
statistical evidence, taken as a whole, is inconclusive.
Q145 Dr Stoate: You cannot take it
as a whole. I am talking about children's health, I am talking
about cot death, glue ear, respiratory illness. You cannot say
there is no statistically compelling evidence that those are attributable
in large measure to environmental tobacco smoke. There is a very,
very close relationship.
Dr Stotesbury: If you listened
to the previous evidence session, even the people giving evidence
were only talking about risk in association with lung cancer and
heart disease.
Q146 Dr Stoate: They were looking
at the big four killers in adults. I am specifically focusing
on the health effects on children. You have said there is no compelling
statistical evidence and I am saying that actually there is, and,
with children in particular, the evidence is very strong.
Dr Stotesbury: I heard them say
there is not much evidence on other diseases.
Q147 Dr Stoate: You are a scientific
officer. You are a trained person. Are you saying they got it
wrong? Are you saying they misled us? Are you saying the evidence
has been interpreted wrongly? I am not clear exactly what you
are saying.
Dr Stotesbury: I am saying there
is insufficient evidence.
Q148 Dr Stoate: I have to disagree
to that. I think particularly with children there is evidence.
We will ask our advisers to produce some strong evidence for us.
Dr Stotesbury: Could I refer to
a study by IARC which was published in 1998 which specifically
looked at that question you raise, disease in relation to children.
Whilst they found a statistical association in adults that was
non-significant—and I can explain that certainly, if you
like—they found no evidence at all of any childhood exposure
and disease.
Q149 Dr Stoate: We will certainly
ask our advisers to get that paper out for us and we will look
at that.
Dr Stotesbury: I can send you
that paper, if you wish.
Dr Stoate: That would be helpful.
Q150 Chairman: Dr Stotesbury, have
you read recently in the BMJ that Winkel et al found a
highly significant risk of heart disease. It is allegedly a good
study in that respect. Have you looked at that evidence at all?
Dr Stotesbury: Yes, I have looked
at that evidence.
Q151 Chairman: Do you think that
is not significant?
Dr Stotesbury: I said earlier
on that the vast majority of the scientific evidence is not flawed.
I think that paper in particular is. They took blood samples that
were 20 years old from the deepfreeze, and looked at responses
to questionnaires recalling over that time. I think you have to
call some of that method into question.
Q152 Chairman: Could I say for the
record that in the written evidence that will be published today
you did use the phrase, "based on flawed science". So"flawed"
was a word that came out of yourmemorandum and not out of the
office of thisCommittee. Could I move on now to MsMohrmann. You
say in your memorandum that you accept the need for some restrictions
on smoking in public in order to protect non-smokers from the
harmful effects of second-hand smoke. Do you believe that ventilation
can provide adequate protection for non-smokers and employees
in the smoking environment? If you do, what evidence do you have
for that?
Ms Mohrmann: We believe that ventilation
is a solution for creating a comfortable environment. We do not
believe ventilation should be the basis for regulation. However,
it should be an option that a business owner can consider if they
are going to allow smoking within their establishment.
Q153 Chairman: Do you have evidence
of that?
Ms Mohrmann: We just think it
is a solution for business owners who like to have smoking in
their establishment, just as it is if they like to have separate
rooms or separate areas, but it is up to that business owner to
take a decision on how they want to develop their smoking policy.
Q154 Chairman: I accept that very
well, but the issue around smoking and its harmful effects and
everything else—and you are familiar with it because you
are a lot closer than certainly most of us in this room—is
more scientific than "think". We have tried, with different
witnesses in this session this morning, to get to the science
of it. You think that ventilation might be better but do you have
any hard study that has been done in relation to ventilation?
Ms Mohrmann: We believe it is
up to the business owner to decide what is best to accommodate
their customers, smokers and non-smokers. Ventilation may be a
solution. We also think that signage, for instance, is very important.
It communicates the policy that that establishment has and we
also believe that Government should also require on that signage
that government and public health officials have concluded that
second-hand smoke is harmful to non-smokers. This way, anyone
entering an establishment can then make a decision about whether
they want to frequent it or not.
Q155 Dr Naysmith: You said it provides
a more comfortable environment. Is that not the case? That is
what you said, is it not?
Ms Mohrmann: Yes.
Q156 Dr Naysmith: It was not that
it had any effect on reducing incidents of any kind of disease
or anything, it was that it created a more comfortable environment
for patrons.
Ms Mohrmann: Yes.
Q157 Dr Naysmith: That is what you
said.
Ms Mohrmann: Yes.
Q158 Chairman: Mr Jenner, do you
have any views on ventilation?
Mr Jenner: Yes, Mr Chairman. We
welcome the opportunity to participate in your deliberations.
Our view is that ventilation does have a role to play. It would
seem to us that it is commonsense that ventilation is better than
no ventilation. It is a mechanism that is widely employed in other
Member States in the European Union. Our company, through the
BSRIA (Building Service Research Information Association) and
other tobacco companies, is engaged to better understand the benefits
of ventilation in a controlled environment. We would quote this
as an example where we try to work with the hospitality associations,
as we have done through the AIR Campaign (Atmosphere Improves
Results). In our fundamental view, it is about getting rid of
the smoke and not the smokers. In this way, we can support the
notion that we can balance people's responsibilities with their
freedoms.
Q159 Dr Stoate: Are you saying that
ventilation is about adequate protection both for non-smokers
in establishments and employees? The evidence we have heard this
morning on BM2.5 from the Royal College of Physicians entirely
contradicts that. They would say, and I believe Mrs Rawlins said
the same, that it improves comfort and the perception of a clean
atmosphere. Does it provide adequate protection for non-smokers
and employees? Yes or no.
Mr Jenner: I do not think it can
be summed up as easily as that, because I do not think I used
the word "adequate". I was at pains to share with you
that I do not think it is fully understood, the benefit. Our view
is that it is commonsense that to have ventilation is better than
none.
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