nice country western nightclub and listen to a good band, but I cannot because the smoke sickens me and the bars are full of it. So, as you can see, I am literally deprived of many enjoyments and even some freedoms because smokers continually feel that they have the right to pollute my air space. They have no right, either real or perceived to do so. I have the right to breath clean air without being poisoned. Seventy-eight percent of us do not smoke and we are under siege by this small minority, not to mention the tremendous health care costs this habit must surely incur. Keep going, Congressman, do not stop. I want to enjoy life without gagging whenever I go out. If there is anything this completely average American can do, do not hesitate to write or call. I have never voted for a democrat in my 31 years of life, but I would vote for you in a heartbeat."

Well, I thank Mr. Leon. I wished he lived in my district, but he does not. I am grateful for his support, and I am even more grateful that he took the time to share his perspective with us. This morning we are going to hear the perspective of children who may be the group most affected by environmental tobacco smoke. I want to welcome Lauren Minor, Megan Udell and Jason Emmons for being with us today. They are going to talk about why they think this legislation is important.

The cigarette companies may not like this bill, but, Lauren, Megan and Jason will make it absolutely clear why we must pass H.R. 3434 this year. It is good for our children and it is good for

us.

Before calling on them, I want to recognize Mr. Bliley, the ranking Republican member of this subcommittee for any comments he wishes to make.

Mr. BLILEY. Thank you, Mr. Chairman. This is the subcommittee's second hearing on H.R. 3434, the Smoke-Free Environment Act of 1993. Mr. Chairman, I appreciate your willingness to hold a second hearing and to include some witnesses at my request. Because this bill is one of the most extreme anti-smoking bill ever considered at any level of Government anywhere in the country, it demands some very careful scrutiny.

I think what we will find at the end of the day is that this legislation is a solution in search of a problem. Anyone who reads the newspaper or listens to the nightly news is aware that private companies, State and local governments, and even Federal agencies are taking steps to accommodate the concerns of their employees and constituents when it comes to environmental tobacco smoke. How many companies and State and local governments have acted to adopt restrictions on smoking? The answer is literally thousands. As we meet today, smoking restriction measures have been adopted by 48 States and literally thousands of local governments.

In addition, as we will hear from some of our private sector witnesses this morning, an overwhelming number of companies have adopted smoking restrictions. According to the most recent comprehensive survey of workplace smoking policies conducted by the Bureau of National Affairs and the Society for Human Resource Management, 85 percent of the private employers who responded to the survey have workplace smoking policies. Forty percent of those employers have implemented total smoking bans and an ad

ditional 34 percent prohibit smoking in all work areas. I think it is important to point out that this survey is now several years old, and so the number of companies with smoking policies is even larger than the 85 percent reported by the survey.

With the voluntary actions taken by large numbers of employees, employers and governments, why is H.R. 3434 necessary? I think it is because the proponents of this legislation are not satisfied to allow companies and other local entities to work out an accommodation between smokers and nonsmokers. What the proponents of this legislation want is a ban on smoking outright. This legislation purports to allow smoking in certain places. It establishes nearly insurmountable obstacles in the way of actually providing such a place. First, the bill says a smoking area must be directly exhausted to the outside. Second, it says the smoking area must be in a place that nonsmokers are never required to enter. Regardless of the cost of creating a smoking area, exhausted separately to the outside, it is hard for me to imagine an area in any public building that a non-smoking individual might not ever have to enter.

I hope it becomes clear today that H.R. 3434 is a very radical proposal, and that it is based on the very radical idea that no amount of environmental smoke is safe. In our first hearing on the bill, I raised my concerns with the scientific underpinnings of EPA's risk assessment on ETS. So, I will not go into that issue again at this time. However, I do feel compelled to note that within the past several days, the Congressional Research Service has completed a report entitled "Cigarette Taxes to Fund Health Care Reform and Economic Analysis."

While I do not agree with every word of the CRS report, I want to draw the subcommittee's attention to CRS's review of EPA's risk assessment. CRS noted, among other things, that, in conducting its risk assessment on ETS, EPA departed from otherwise applicable standards in judging ETS, after finding that ETS could not be declared to be harmful without such a departure. The CRS report noted, with a touch of understatement, I think: "It is unusual to return to a study after the fact, lower the required significance level, and declare its results to be supportive, rather than unsupportive of the effects one's theory suggests should be present."

I would like to ask unanimous consent, Mr. Chairman, that the complete text of CRS's review of EPA's risk assessment be included in the record.

Mr. WAXMAN. Without objection, that will be so ordered.

Mr. BLILEY. Thank you, Mr. Chairman. I think we need to take a comprehensive look at the problem of indoor air quality. I will be interested to hear from some of our witnesses this morning how many indoor air problems are the result of cigarette smoking and how many are the result of other problems. I am aware that some office buildings continue to have very serious indoor air quality problems even after smoking is banned. To address just one possible source of indoor air contamination and in a way that is neither rational nor effective, is not serving the public's interest. Thank you, Mr. Chairman. I look forward to the testimony of the witnesses.

[The CRS report follows:]

Cigarette Taxes to Fund Health
Care Reform: An Economic
Analysis

CRS-45

APPENDIX A: EVIDENCE ON PASSIVE SMOKING EFFECTS

The Manning study data do not indicate much of an effect of increased health costs from passive smoking. These data are used to calculate the health care costs of active smoking, but not passive smoking.60

The claim that passive smoking results in damage to the health of nonsmokers is based upon both theory and empirical analysis. In this view, the theoretical case for the existence of passive-smoking effects is considered to be sound and leads investigators to expect to find empirical support for the proposition.

This theoretical case that passive smoking imposes external costs on nonsmokers can be summarized in three steps: (1) environmental tobacco smoke has the same components as smoke inhaled by smokers; (2) there is physical evidence of some absorption of these components; and (3) a positive relationship exists between active smoking and additional disease and health costs.

Questions have been raised about this entire chain of reasoning, but the focus here is the third link in the chain. This link is based upon evidence on active smokers who report different amounts of smoking. Even the lightest smokers among active smokers, however, experience far greater exposure to and absorption of disease-causing agents than do passive smokers. Such evidence on active smokers is necessary but not sufficient to conclude that a similar relationship exists for passive smokers. It is entirely plausible that the (unknown) health effects/physical damage function rises very little over the range of exposure levels for passive smokers and begins to rise rapidly as the physical damage levels experienced by active smokers are approached.

The existence of an exposure threshold for disease onset below which many passive smokers fall is not implausible. Most organisms have the capacity to cleanse themselves of some level of contaminants. It is for this reason that public policy usually does not insist that every unit of air or water pollution be removed from the environment; the damage of low levels of pollutants is sufficiently small (through the self-cleansing process) that removal is not cost effective. In fact, strongly nonlinear relationships in which health effects rise with the square of exposure, and more, have been found with respect to active smoking (see Surgeon General's Report, 1989, p. 44). Were these relationships projected backward to construct the lower (unknown) portion of the health effects/physical damage function, the observed relationship might lead researchers a priori to expect no empirical relationship. Thus, the issue raised by this potential break in the causative chain is whether researchers should expect to find a significant relationship between passive smoking and health effects.

60 The Manning study uses other data to make some calculations on the cost of cancer deaths from passive-smoking. The details of these calculations are unclear and the results appear to be inconsistent with the remainder of the study.

CRS-46

A number of epidemiological studies have assessed the effects of environmental tobacco smoke on specific diseases, with the largest body of research focusing on lung cancer among nonsmoking wives of smokers. There have also been a number of studies on heart disease in spouses of smokers and general respiratory illnesses in children. Based upon these studies, several Government agencies have, in the last few years, taken the position that environmental tobacco smoke causes health hazards, including the Office of the Surgeon General and the Environmental Protection Agency (EPA).61 These hazards include lung cancer risks in nonsmoking adults and respiratory effects in children. EPA issued a risk assessment in 1992 that classifies environmental tobacco smoke as a cancer-causing agent.

The positions taken on passive smoking's effects on health by Government agencies and by the EPA 1992 assessment in particular have been subject to criticism by the tobacco industry and by some researchers.62 The following discussion of the lung cancer effect draws on the evidence presented on both sides of the passive smoking issue with regard to the statistical and scientific evidence.63

First, critics have questioned how a passive smoking effect can be discerned from a group of 30 studies of which six found a statistically significant (but

61 U.S. Department of Health and Human Services, The Health Consequences of Involuntary Smoking, 1986, Surgeon General Report, DHHS Publication Number (CDC) 87-8398; and United States Environmental Protection Agency (1992).

62

A group of tobacco growers and manufacturers has filed a lawsuit challenging the EPA assessment as not being supported by the evidence. Among the issues raised is the use of empirical work based upon exposure in the home to draw inferences about health effects from exposure in the workplace.

63 These sources include the U.S. Department of Health and Human Services, Surgeon General Reports for 1986 and 1989; United States Environmental Protection Agency (1992), which detail the rationales for their positions. These reports also summarize the epidemiological studies on environmental tobacco smoke, especially on lung cancer and childhood respiratory illness. The reader is also referred to a hearing at which researchers who both supported and criticized the EPA study appeared: U.S. Congress, House Committee on Agriculture Subcommittee on Specialty Crops and Natural Resources, Review of the U.S. Environmental Protection Agency's Tobacco and Smoke Study, 103rd Congress, 1st Session, July 1993. For a view that questions the passivesmoking hazard, focusing particularly on lung cancer, and that is written for the layman, see Gary L. Huber, Robert E. Brockie and Vijay Mahajan, "Passive Smoking: How Great a Hazard?" Consumers' Research, July 1991, 10-15, 33-34. Huber, et al. also wrote a companion paper on cardiovascular disease "Passive Smoking and Your Heart," Consumers' Research, April 1992, pp. 13-19, 33-34. Finally, see Kyle Steenland, "Passive Smoking and the Risk of Heart Disease," Journal of the American Medical Association, January 1, 1992, Vol. 267, pp. 94-99. These last two articles provide capsule summaries of epidemiological studies on passive smoking and heart disease. Finally, see The Tobacco Institute, EPA Report Scientifically Deficient for a summary of the industry's criticism of the EPA report. Some critics of the claim that passive smoking causes disease have also raised questions about institutional bias in the Government or in the professional journals; those issues are not addressed here.