Environmental Tobacco Smoke: Incomplete Research or Author Bias?
Environ Health Perspect 115:A439-A443 (2007). doi:10.1289/ehp.10233 available via http://dx.doi.org [Online 15 August 2007]
Referencing: The Tobacco Industry's Role in the 16 Cities Study of Secondhand Tobacco Smoke: Do the Data Support the Stated Conclusions?
As primary author and co-principal investigator of the 16 Cities Study (Jenkins et al. 1996), I was disappointed to read the article by Barnes et al. (2006). Their methodology, relying solely on Internet-based searching of trial and hearing testimony, tobacco industry documents, and other information, was clearly incomplete and suggests poor investigatory skills and/or deliberate selection of data or information to support a preconceived notion of the complex processes involved with the conception, conduct, data reporting, and interpretation of what became known as the 16 Cities Study.
One example (there are many) of the errors presented by Barnes et al. (2006) is the paragraph on page 1895 devoted to highlighting the fact that in the Broin flight attendant class action lawsuit, Judge Robert Kaye ruled (mistakenly I believe) that I could not rely upon the 16 Cities Study in my testimony for that case. What the authors failed to mention is that in the Dunn-Wiley environmental tobacco smoke (ETS) trial in Muncie, Indiana, less than 6 months later (Dunn and Wiley v. RJR Nabisco Holdings Corp, et al. 1998), Delaware Superior Court 1 Judge Robert Barnet Jr. overruled a similar motion by the plaintiffs, and noted that he did not find the motion well taken. Did Barnes et al. simply miss that ruling in their search for information, or did they ignore it?
Probably the most egregious distortions of the facts lies in the claims of Barnes et al. (2006) that we failed to make the Occupational Safety and Health Administration (OSHA) or the public aware of RJ Reynolds' involvement in the field or analytical laboratory work done for the 16 Cities Study and/or tobacco industry sponsorship of the study, and that although we ultimately did publish papers regarding the impact of smoking restrictions on
workplace exposures, those papers were "published long after the close of the OSHA proceedings, . . . ." (Barnes et al. 2006, p. 1896). Although the authors cited my 5 January 1995 OSHA testimony, they did not mention the ≥ 1,000-word explanation of the role of RJ Reynolds and Bellomy Research in the 16 Cities Study in my formal presentation to OSHA (OSHA 1995). Neither did they mention the discussions during my questioning regarding the work flow in the study or the pages of discussions regarding the contractual arrangements between Martin Marietta Energy Systems [Oak Ridge National Laboratory's (ORNL) prime contractor at the time] and the Center for Indoor Air Research, the study's sponsor. More importantly, in the first article on the 16 Cities Study (Jenkins et al. 1996; p. 475), a paragraph is devoted to the tasks and responsibilities of the three institutions (ORNL, RJ Reynolds, and Bellomy Research). On pages 480, 481, and 483, there is a detailed discussion of the work flow, quality control, and data inspection among the three institutions. Finally, on page 500, we acknowledged the funding source for the study and the contributions of key individuals from the other two institutions. Did Barnes et al. (2006) just miss the aforementioned discussions, or did they ignore them?
As to the issue of whether OSHA was made aware of the impact of workplace smoking in a timely fashion, the contention of Barnes et al. (2006) is false. In fact, as part of its deliberations, OSHA conducted expert workshops on exposure assessment, health effects, and ventilation beginning in September 1997. Both S.K. Hammond and I, along with others, were invited participants of the workshop on exposure assessment held at Johns Hopkins University on 12–13 September 1997. At that workshop, I provided a variety of analyses to the panel, including one concerning the impact of smoking restrictions on personal exposures to ETS in the workplace. That analysis was eventually published (Jenkins and Counts 1999). For Barnes et al. to claim that we did not make OSHA aware of the impact of workplace smoking restrictions on exposure before the close of the proceedings, when one of the authors was present at an OSHA expert workshop that was part of OSHA's "proceedings" where I presented the data analyses in question, is both astounding and false.
The 16 Cities Study stands as the largest and most representative study of personal exposure to ETS ever conducted in the United States. The methodology used was sound and the findings scientifically valid. Seven peer-reviewed papers have been published from its work, including one in Environmental Health Perspectives. If Barnes et al. (2006) disagree with the manner in which we organized or interpreted the data in those seven articles, I would point out that a flat-field version of our 16 Cities Study results database has been available to the public since at least 2000 through either the Sapphire Group (Gevecker Graves et al. 2000), or from the Oak Ridge National Laboratory's web site (Oak Ridge National Laboratory 2005). We have always welcomed fresh eyes on our data, and we are disappointed that Barnes et al. appear not to have taken advantage of its availability.
Science is about a dispassionate analysis of the facts—all the facts. All of the facts must be analyzed, even if they do not support a hypothesis or preconceived outcome of the analysis. Anything less can be considered poor science or, at worst, politics.
The author currently sits on the Board of Directors of the Institute for Science and Health, a nonprofit organization focusing on underresearched diseases, which has received unrestricted grants from tobacco companies; he also serves on the organization's Tobacco Science and Health Policy Advisory Council. In addition, the author has acted as a subcontractor to the Oak Ridge National Laboratory (which acts as a subcontractor to the University of Kentucky's Biomedical Engineering School, which is in turn funded for this work by a grant from the External Research Program of Philip Morris, USA). He is also involved in litigation regarding environmental tobacco smoke exposure.
Roger A. Jenkins
Consultant
Bozeman, Montana
References
Barnes RL, Hammond SK, Glantz SA. 2006. The tobacco industry's role in the 16 Cities Study of secondhand tobacco smoke: do the data support the stated conclusions? Environ Health Perspect 114:1890–1897.
Dunn and Wiley v. RJR Nabisco Holdings Corp, et al. 1998. Case No. 18D01-9305-CT-06, Deleware Superior Court, Indiana. Trial transcript from 4 March 1998.
Gevecker Graves C, Ginevan ME, Jenkins RA, Tardiff RG. 2000. Doses and lung burdens of environmental tobacco smoke constituents in nonsmoking workplaces. J Expo Anal Environ Epidemiol 10(4):365–377.
Jenkins RA, Counts RW. 1999. Occupational exposure to environmental tobacco smoke: results of two personal exposure studies. Environ Health Perspect 107(suppl 2): 341–348.
Jenkins RA, Palausky A, Counts RW, Bayne CK, Dindal AB, Guerin MR. 1996. Exposure to environmental tobacco smoke in sixteen cities in the United States as determined by personal breathing zone air sampling. J Expo Anal Environ Epidemiol 6:473–502.
Oak Ridge National Laboratory. 2005. Environmental Tobacco Smoke Characterization and Exposure: Explanation of 16 Cities Study Database. Available: http://www.ornl.gov/sci/csd/Research_areas/ecms_rd_etsce_16cities.html [accessed 9 July 2007].
OSHA (Occupational Safety and Health Administration). 1995. Transcript of Public Hearing on Proposed Standard for Indoor Air Quality, Docket No. H-122.
Environmental Tobacco Smoke: Barnes et al. Respond
Environ Health Perspect 115:A439-A443 (2007). doi:10.1289/ehp.10233R available via http://dx.doi.org [Online 15 August 2007]
We are gratified that Jenkins does not dispute the central findings of our study (Barnes et al. 2006), namely, that a) the 16 Cities Study grew out of the tobacco industry's plan to block any Occupational Safety and Health Administration (OSHA) standard on secondhand tobacco smoke; b) RJ Reynolds Tobacco was the originator of the 16 Cities Study and exercised substantial control of the research at all times; c) Jenkins et al. (1996) combined exposure data from restricted and unrestricted smoking workplaces and compared exposure data in an inappropriate manner that produced results the industry could cite to support its claim that workplace secondhand smoke (SHS) exposures were low compared with household exposures during its efforts to defeat indoor smoking restrictions; and d) a proper analysis of the data Jenkins presented indicates that smoke-free policies would halve the total SHS exposure of those living with smokers and virtually eliminate exposure for most others, supporting the need for smoke-free workplaces [and the polar opposite conclusion of Jenkins et al. (1996)]. [Compare Figures 1 and 2 of our article (Barnes et al. 2006)].
The disagreement appears to be in how transparent or opaque these facts were to the reader of Jenkins' original article on the 16 Cities Study (Jenkins et al. 1996) and to OSHA.
In his letter, Jenkins ignores our Table 2 (Barnes et al. 2006), which contrasts the actual roles that RJ Reynolds and other agencies played in the design, conduct, and management of the 16 Cities Study compared with how these roles were described by Jenkins in his publications and direct testimony. We did not say that he did not disclose that he was working for the tobacco industry; we presented evidence that the disclosures in his articles did not completely reflect the role that the industry played in conceiving of and controlling the study. In addition, lengthy cross-examination of Jenkins during the OSHA hearings was required to reveal the extensive involvement of RJ Reynolds, and that revelation was incomplete (OSHA 1995).
We also would like to address a few other small points. First, far from "deliberate selection of data," we followed standard snowball methodology (Malone and Balbach 2000) for searching the industry documents; we identified > 500 relevant industry documents, as well as court records and the published literature, as a basis for our article (Barnes et al. 2006). We did analyze the full public 16 Cities data set when preparing our article, but we did not cite it because we were able to present our analysis based on summary results from the published articles (Jenkins and Counts 1999; Jenkins et al. 1996). We did not mention the Dunn–Wiley trial (Dunn and Wiley et al. v. RJR Nabisco Holdings Corp. et al. 1993) in Indiana because the ruling was on a motion to strike Jenkins' testimony because of procedural issues relating to disclosure of expert witness testimony in advance of trial, not a challenge to the conduct of the 16 Cites Study, as made in the Brion case (Dunn and Wiley et al. v. RJR Nabisco Holdings Corp. et al. 1998).
Nothing in Jenkins' letter contradicts our conclusion that he and his colleagues presented the data from the 16 Cities Study in a way that conformed to the stated objective of the Tobacco Institute's "OSHA Projects" to "encourage adoption of a ventilation standard and to discourage adoption of a smoking ban or of a standard that requires separate ventilation for areas where smoking is allowed" (Tobacco Institute 1991). Indeed, as noted above—and unchallenged by Jenkins—a proper presentation of the 16 Cities data [Figures 1 and 2 of Barnes et al. (2006)] shows that employees in "smoking workplaces" have significant levels of SHS exposure and that smokefree workplaces substantially reduce overall exposure to SHS. This conclusion remains important because the tobacco industry and its allies still rely heavily on the 16 Cities Study in opposing regulation of SHS exposures.
S.K.H. reviewed Jenkins' documents for OSHA during its hearing on SHS in the workplace in 1994–1995. S.A.G. testified on behalf of OSHA in the same hearing on other issues related to SHS. Neither has any current relationship with OSHA. R.L.B. declares he has no competing financial interests.
Richard L. Barnes
Stanton A. Glantz
University of California, San Francisco
San Francisco, California
S. Katharine Hammond
University of California, Berkeley
Berkeley, California
References
Barnes RL, Hammond SK, Glantz SA. 2006. The tobacco industry's role in the 16 Cities Study of secondhand tobacco smoke: do the data support the stated conclusions? Environ Health Perspect 114:1890–1897.
Dunn and Wiley et al. v. RJR Nabisco Holdings Corp. et al. 1993. Cause No. 18D01-9305-CT-06, 28 May 1998, Superior Court, Delaware County, Indiana.
Dunn and Wiley et al. v. RJR Nabisco Holdings Corp. et al. 1998. Cause No. 18D01-9305-CT-06, 5 March 1993, Superior Court, Delaware County, Indiana, 6323-6368. Available: http://legacy.library.ucsf.edu/tid/qkg35a00 [accessed 5 February 2005].
Jenkins RA, Counts RW. 1999. Occupational exposure to environmental tobacco smoke: results of two personal exposure studies. Environ Health Perspect 107(suppl 2): 341–348.
Jenkins RA, Palausky A, Counts RW, Bayne CK, Dindal AB, Guerin MR. 1996. Exposure to environmental tobacco smoke in sixteen cities in the United States as determined by personal breathing zone air sampling. J Expo Anal Environ Epidemiol 6:473–502.
Malone RE, Balbach ED. 2000. Tobacco industry documents: treasure trove or quagmire? Tob Control 9: 334–338.
OSHA (Occupational Safety and Health Administration). 1995. Proposed Standard for Indoor Air Quality: ETS Hearings, January 5, 1995, 9733–9957. Available: http://www.tobacco.org/Documents/osha/950105osha.html [accessed 9 July 2007].
Tobacco Institute. 1991. EPA Projects, OSHA Projects. Bates No. 87717939/7947. Available: http://legacy.library.ucsf.edu/tid/mgj21e00 [accessed 9 September 2004].