摘要：Objectives. We studied tobacco industry efforts during the 1980s and 1990s to promote the National Energy Management Institute (NEMI), a nonprofit organization, as an authority on indoor air quality as part of the industry's strategy to oppose smoke-free worksite policies. Methods. We analyzed tobacco industry documents, conducted literature searches in Lexis–Nexis for background and historical literature, and reviewed relevant public health and policy literature. Results. The tobacco industry provided more than US $6 million to NEMI to establish it as an authority on indoor air quality and to work with it to undermine support for smoke-free air policies by promoting ventilation as a solution to indoor air quality problems. Tobacco industry support for NEMI was not publicly disclosed. Conclusions. NEMI was a valuable ally for the tobacco industry through NEMI's ties to organized labor, its technical background, and its status as a third-party actor. NEMI also helped the industry to portray ventilation to improve overall indoor air quality and smoke-free worksites as an either–or choice; in fact, both can improve worker health. In the 1980s, the National Energy Management Institute (NEMI), a nonprofit association of sheet metal contractors, and the Sheet Metal Workers International Association (SMWIA) became active advocates for improving indoor air quality. NEMI promoted ventilation, rather than source control, to solve indoor air problems. NEMI made presentations at trade shows and conferences, published a quarterly newsletter, offered legislative testimony at the state and federal levels, and gave media interviews about clean indoor air. 1 – 5 Although NEMI was expansive in proclaiming its indoor air quality expertise, it was less forthcoming about its financial support from the tobacco industry. The tobacco industry had a significant interest in undermining efforts to control the sources of indoor pollution, such as smoke-free worksite policies. It pursued this interest by arguing that ventilation could improve indoor air quality, which, it further argued, would eliminate the need to ban smoking indoors. Smoke-free worksites threatened the industry's economic interests by reducing cigarette consumption and undermining the social acceptability of smoking. 6 – 8 Between 1987 and 1998, the tobacco industry (via the Tobacco Institute, the trade association for US tobacco companies) provided more than US $6 million to NEMI, 9 – 18 which promoted the industry's message that tobacco smoke is a minor contributor to indoor air problems. 8 , 19 NEMI's interests were also served by this focus, as stronger ventilation standards meant more work for sheet metal contractors and workers. Tobacco Institute funding for NEMI is shown in Table 1 . TABLE 1 Tobacco Institute Funding for the National Energy Management Institute, 1987–1998 Funding Breakdown Year Total Funding, $ General Support, $ Develop/Distribute IAQ Protocol, $ Spokes- persons, $ Promotional Activity, $ IAQ Training Sessions, $ Promotion of IAQ Legislation, $ Federal/State Projects, $ Building/Other Studies, $ Media Promotion, $ Other, $ 19879 180 000 … 180 000 … … … … … … … … 19889 200 000 … 100 000 50 000 50 000 … … … … … … 198910 205 000 … 125 000 50 000 25 000 … … … … … 5 000 199011 620 000 … 50 000 200 000 200 000 170 000 30 000 … … … … 199112 636 000 … 30 000 200 000 200 000 75 000 … 96 000 25 000 10 000 … 199213 790 000 … 50 000 200 000 150 000 60 000 … 225 000 60 000 25 000 … 199314 830 000 … 50 000 200 000 125 000 60 000 … 325 000 70 000 … … 199415 780 000 … … 200 000 125 000 60 000 … 325 000 70 000 … … 199516 850 000 500 000 … … … … … … 290 000 … 60 000 199617 560 000 310 000 … … … … … 250 000 … … … 199717 560 000 310 000 … … … … … 250 000 … … … 199818 420 000 420 000 … … … … … … … … … Open in a separate window Note . IAQ = indoor air quality. Ellipses indicate no funding. By supporting NEMI, the tobacco industry concealed its involvement in policy debates, 20 a strategy it had used before to contest tobacco control initiatives. For example, the industry sponsored scientists and consultants to challenge scientific evidence on the negative effects of environmental tobacco smoke, 21 – 24 a strategy that Michaels and Monforton describe as “manufacturing uncertainty.” 25 (pS39) With NEMI, however, the industry had a slightly different challenge. NEMI's technical background centered on the energy management aspects of building systems, not ventilation systems. 26 NEMI's usefulness to the tobacco industry in the policy arena was contingent on its ability to develop a recognized program promoting ventilation to improve indoor air quality. 19 , 27 , 28 More than manufacturing uncertainty, the challenge was to manufacture credibility for NEMI so that it could be an important advocate for the indoor air quality strategy. Through this relationship, the tobacco industry gained an important ally in its efforts to build support in the labor community for indoor air quality and ventilation initiatives, and NEMI gained the skills and visibility to penetrate the indoor air quality market. The tobacco industry's role in NEMI's indoor air quality and ventilation program only became public after 1998, with the release of internal documents as a result of litigation. Public health advocates must understand industry political strategies to undertake effective policy campaigns. Thus, we used tobacco industry documents produced through the litigation process to examine the industry's efforts to manufacture credibility for NEMI, preparing it to be a key ally in their indoor air quality and ventilation strategy.
