摘要：Objectives. This review details the tobacco industry's scientific campaign aimed against policies addressing environmental tobacco smoke (ETS) and efforts to undermine US regulatory agencies from approximately 1988 to 1993. Methods. The public availability of more than 40 million internal, once-secret tobacco company documents allowed an unedited and historical look at tobacco industry strategies. Results. The analysis showed that the tobacco industry went to great lengths to battle the ETS issue worldwide by camouflaging its involvement and creating an impression of legitimate, unbiased scientific research. Conclusions. There is a need for further international monitoring of industry-produced science and for significant improvements in tobacco document accessibility. Concerns regarding the health effects of environmental tobacco smoke (ETS) began as early as 1973 when the US Civil Aeronautics Board required nonsmoking areas on all commercial airplanes. Arizona and Minnesota became the first US states to restrict indoor smoking to designated areas with the enactment of clean indoor air acts in 1973 and 1975, respectively. The US surgeon general's 1979 report concluded that ETS exposure should be considered a separate scientific issue from active smoking. 1 Investigation of ETS as a source of indoor air pollution and a potential carcinogen increased throughout the 1980s. 2 – 5 An early 1990s investigation of the association between heart disease and ETS showed that approximately 37 000 annual heart disease deaths among nonsmokers occur in the United States owing to ETS exposure, 6 a finding supported by subsequent research. 7 In January 1990, 2 years after airliner cabin air quality was addressed, the US Environmental Protection Agency (EPA) released a draft risk assessment reporting that 3800 lung cancer deaths per year were attributable to ETS. 8 The final EPA report, Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders , was released on January 13, 1993, and attributed 3700 annual US lung cancer deaths to ETS exposure. 8 (The EPA report was completed in December 1992; therefore, it is commonly referred to as the “1992 EPA report.”) Five months after the release of the report, representatives of the tobacco industry filed suit against the EPA in an attempt to force withdrawal of the conclusion that ETS was a group A carcinogen. In 1998, after a 5-year court battle, Judge William L. Osteen voided EPA's classification of ETS as a group A carcinogen. The judge did not, however, vacate other EPA findings regarding ETS and various respiratory disorders. 9
