Big Drugs, Pregnancy And Social Marketing II

By Norman E. Kjono, July 8, 2007

Copyright © 2007 Norman E. Kjono


"5. Do you contend that there is a causal relationship - versus an observed association - between pregnant mother's exposure to ETS and child behavior pathology? 

"What we are suggesting is that when exposure is chronic, the nicotine absorbed into the mother's blood passes to her fetus and affects brain development.  This is supported by the findings that the developing brain is supremely sensitive to nicotine and is affected at doses lower than those required to affect physical growth.  We often associate smoking with a risk for "low birth weight", but the brain is affected at lower doses than those required to reduce birth weight.  The Surgeon General released a report last year documenting the extensive dangers of second hand smoke exposure- including those to the fetus of an exposed mother.  Our study aimed to extend the documentation of risks into psychological well being as well as physical health. Our study in (sic) unable to draw conclusions about causality, a consequence of doing research with humans instead of animals.  But a large body of research gives us good reason to suspect a direct link, and to take appropriate measures both personally, and through public policy, to protect women and their babies from potential harm. " (Underline, italic added.) 

Lisa Gatzke-Kopp, University of Washington, Department of Psychology

Coauthor "Direct and Passive Prenatal Nicotine Exposure and the Development of Externalizing Psychopathology"

July 6, 2007 E-Mail Interview Response

July 6, 2007 published Big Drugs, Pregnancy and Social Marketing. That commentary discussed a recent University of Washington Department of Psychology study that associates pregnant mother's exposure to Environmental Tobacco Smoke (ETS) with later child behavioural problems. The study references pregnant mother's exposure to ETS in the home through spousal smoking and at work in bars and restaurants. Such references are consistent with tobacco control's current agenda to expand smoking bans to residential apartments and condominiums as well as hospitality trade workplaces such as taverns and restaurants. This work provides written interview responses from one of the study authors, discusses the responses in context of additional facts about Environmental Tobacco Smoke (ETS), and presents information concerning the economic impact of statewide smoking bans on independent hospitality trade small businesses.  

As part of my research and writing about tobacco control I often interview or engage in other discussions with researchers and tobacco control advocates. See for example, a debate with University of California at San Francisco tobacco control advocates Stanton Glantz on Voice of America (VOA debate). My columns on Forces often include comments by readers or small business owners and employees adversely affected by statewide smoking bans. Folks in several states have been provided a voice in my recent series about opposition to smoking bans, which included Opposition to Smoking Bans Heats Up VI and Opposition to Smoking Bans Heats Up - Epilogue.  On occasion I also include opposing views from researchers associated with tobacco control studies. My June 2001 series  The Duke of Nicotine included opposing views by Duke University's Professor Jed Rose (a nicotine patch technology patent holder) about the curious recommendation in a study he co-authored that smokers should use Nicotine Replacement Therapy products in conjunction with smoking "De-nicotinized" cigarettes such as Philip Morris' NEXT brand to quit smoking (see Prof. Rose's statement, and Mr. Kjono's response). In short, munch GlaxoSmithKline's Nicorette gum or slap its NicoDerm CQ patch on your butt while smoking Philip Morris NEXT nicotine-free cigarette as part of a recommended smoking cessation program. A better example of using tobacco control advocacy to simultaneously promote the interests of Big Tobacco and Big Drugs could not be found.  

I firmly believe that where meaningful, earnest dialog exists tobacco control and associated anti-obesity agendas cannot successfully operate. That occurs because once the facts emerge from both sides of the issue anti-tobacco predictably loses on both the merit of its programs and the nature of self-serving, mercantile policies behind them. Accordingly, I view actions that engage and publish earnest - often aggressive and contentious - public dialog between opposing camps is not only beneficial in shaping legitimate public policy but is also consistent with Forces' public education goals.  

I also believe that meaningful, earnest dialog is important because by doing so we are able to identify and address underlying issues or motivations that in the long run are far more important than the particulars about one study's conclusions or underlying data. To do so each study must be considered in light of the policy agendas behind it and its impact on others through application in the public realm. Just no one is an island because they are connected to all others in one manner or the other, no individual research study is a final bastion of truth. It is by examining the study in light over-arching policy objectives and its impact on others that we determine the true applicability and worth of what individual researchers may conclude.  

In keeping with such practices, I sent a series of interview questions via E-Mail to the authors of the above-referenced University of Washington study. The E-Mail was addressed to the two study authors, Associate Professor Theodore Beauchaine and post-graduate researcher Liza Gatzke-Kopp, as well as the Chair of the university's Department of Psychology.  The excerpt that appears at top of page 1 in this commentary is Ms. Gatzke-Kopp's verbatim response to the fifth and final subject area in that interview outline. At the time of publication for this work responses had not been received by either Associate Professor  Beauchaine or the chair of the university's psychology department. For the full text of my original five subjects of inquiry and related questions, plus Ms. Kopp's unedited responses, please see Lisa Kopp UW July 6, 2007 Response.PDF.

Issues Background

The importance of connecting the dots between mental health and tobacco control cannot be overstated. During the 109th Congress Senate Bill 1074, the "Healthy Lifestyles and Prevention America Act," was introduced. That legislation was crafted to subsume anti-tobacco, anti-obesity and mental health into one overarching federal program. The legislation also included U.S. Food and Drug (FDA) regulation of tobacco and paved the way for nationwide smoking bans. In addition, S.1074 created a system of federal grants. S.1074 consolidated health advocacy under one federal umbrella, expanded federal powers concerning tobacco, obesity and mental health, and created vast financial incentives for state, local, university research, and advocacy group participation. Similar legislation is before the 110th Congress. A separate bill is before the current Congress to grant FDA authority to regulate tobacco. 

I discussed S.1074 in September 2006 as part of a larger work titled "Tobacco Control, Philip Morris and FDA regulation of Tobacco." As explained in that work, the biggest of Big Tobacco, Philip Morris, is a principal and sustaining beneficiary of such legislation.  Philip Morris announced its "Smoke Free" Aria nicotine inhaler in October 2005. In addition, Philip Morris is marketing Skoal and other smokeless tobacco products in a joint venture with US Smokeless Tobacco. As this is written Philip Morris is reportedly test marketing alternative cigarette devices that heat rather than burn tobacco and consequently do not produce ETS. Not surprisingly, Philip Morris actively supports both smoking bans and FDA regulation of tobacco. Accordingly, many refer to FDA regulation of tobacco as the "Marlboro Monopoly Act." We observe many who hold themselves out to be arch foes of Big Tobacco in fact advocating public policy and actively participating in grant funded research programs that directly support and advance the mercantile interests of Big Tobacco.  

Needless to say, Big Drugs also handsomely benefit from anti-tobacco, anti-obesity and mental health. Notably, GlaxoSmithKline distributes Nicotine Replacement Therapy (NRT) products NicoDerm CQ patches, Nicorette gum, and Commit nicotine lozenges. In addition, GlaxoSmithKline's Alli diet pill recently began Over-the-Counter distribution. Johnson & Johnson subsidiary ALZA Corp. manufactures NicoDerm CQ for GlaxoSmithKline. Through its acquisition of Pfizer Consumer Healthcare in 2006 for a reported price of $16.6 billion Johnson & Johnson now has an interest in Nicorette as well. One of the top five institutional shareholders of Johnson & Johnson reported by Yahoo Finance, the Robert Wood Johnson Foundation, has also committed $446 million in grants to tobacco control 1992 to 2005. The foundation directly benefits from tobacco control advocacy by and through capital appreciation of its reported $3.9 billion holdings of JNJ stock as well as dividend revenues streams derived therefrom. Finally, as reported in the first work of this series, GlaxoSmithKline's PAXIL is used to treat depression and the company also manufactures products to treat other mental health conditions such as Attention Deficit Disorder. Both medical conditions are discussed in the University of Washington's study concerning ETS exposures and pregnant mothers.    

On July 6, 2007 and today I write concerning a mental health study that the authors disclose was funded by a federal grant from the National Institute of Mental Health (reportedly grant No. R01 MH63699.) The study directly connects mental health to tobacco control through its conclusions, which provide direct support for tobacco control's agendas concerning smoking bans. Moreover, we observe an apparent direct application of federal grants to support unified advocacy of the multiple subjects of anti-tobacco and mental health. Accordingly, I conclude that we are observing and discussing the practical carrying out of the purposes of the 109th Congress' S.1074, regardless of the status of the Healthy Lifestyles and Prevention America Act before the 110th Congress.  

While the stated goals of health advocacy programs may be considered by some to be noble we must also consider the predictable costs to others associated with pursuing them. History is replete with examples that noble goals often equal nobles' benefit at commoners' expense. Noble prerogatives absent noblesse oblige often equals revolution. In the case of U.S. public policy the revolution is properly advanced through dialog rather than use of arms. This phenomenon at once frames the issues and presents a question that we the people must ultimately address: 

To what ends are United States public policy directed, to achieve mercantile advantage through regulatory manipulation or to produce the highest and best good for the people? 

Carrying out and enabling political agendas regardless of legislative approval or judicial status appears to be a highly controversial subject in American politics today. Considering that reality, I believe the subjects addressed in this work rise to matters of compelling public interest. 

1.0 The Absence of Proof = Overwhelming Evidence 

Ms. Kopp's response may be accurately paraphrased as: "Even though our study does not and cannot establish causality between prenatal exposure to ETS and later child behavioural problems we suspect that such a link may exist and will therefore advocate public policy measures to protect women and their babies from a potential risk that may conceivably occur."  

Based on such research statements tobacco control advocates and their media supporters will tout the "fact" that the evidence concerning deadly consequences of ETS exposure is "overwhelming" and that "the debate is over" concerning that subject. The short form of that view is "what has not been established and cannot be proven conclusively proves the health risks that we proclaim."  

Considering the above, it is alarming that on June 28, 2007 the Seattle Times published the following statement in its news article by staff reporter Warren King, titled "Secondhand Smoke May Affect Brain of Fetus:"  

In a study released Wednesday, scientists found that children who have such psychological problems have a higher frequency of them -- or more severe troubles -- if their mothers were regularly exposed to tobacco smoke while pregnant. Those troubles include Attention Deficit Hyperactivity Disorder (ADHD), aggressive behavior, defiance and a behavior pattern called conduct disorder, which can include truancy, fighting, failing in school, substance abuse, theft and property destruction. "Parents should be really aware of the [fetal] brain development going on during pregnancy," said psychologist Lisa Gatze-Kopp, lead investigator of the study, which was reported in the current issue of the journal Child Psychiatry and Human Development. . . . Mothers exposed to nicotine -- the smoking mothers and the secondhand smoke mothers -- generally had children with more severe problems with attention or more severe emotional and behavioral problems than the children of nonsmokers, said Gatzke-Kopp. She said the findings could extend to all children whose mothers were exposed to tobacco smoke during pregnancy." (Underline added.) 

There is nothing unequivocal or left to doubt in The Times' article. Children of mothers who were exposed to tobacco smoke have higher frequency and more severe behavioural troubles. Nicotine is identified as the substance linked to the conclusive finding that mothers who were exposed to ETS "generally had children with more severe problems." In the hands of Times reporter Warren King mere suspicion for which study authors state in writing a causal relationship has not and cannot be established becomes a certain fact. The pens used by reporters at The Times must have magical transformative powers: a causal relationship that the study authors deny flows as established fact from reporter's pens to the public eye, and The Times ups the ante by also quoting the study author to state "the findings could extend to all children whose mothers were exposed to tobacco smoke during pregnancy."  

We observe mainstream media aggressively supporting tobacco control advocacy for public policy that expands smoking bans to private apartment rental residences, bars and restaurants. Support is rendered by transforming a speculative hypothesis into established scientific fact with the stroke of a reporter's pen. That support is provided with a statement equivalent to, "Since there was overwhelming suspicion that Weapons of Mass Destruction may exist in Iraq when we invaded in 2003 there is now compelling evidence for the need to have an expanding troop surge in 2007." That approach may work in the arena of political neo-con-speak but I believe that it is hardly appropriate for credible university research endeavor.  

When reading such news reports one is reminded of peer review for the Japanese Otsuka study published in July 2001 by the Journal of the American Medical Association (JAMA). I addressed the Otsuka study in the third section (HTML page 3) of "A Short Course in Politics and Environmental Tobacco Smoke." That study claimed to establish a clear causal relationship between exposure to secondhand smoke and heart disease. Problem is, like the University of Washington's study discussed herein, the Otsuka did not measure or quantify ETS exposure, yet the study attributes a clear and certain causal relationship between exposure to ETS and adverse health effects. 

1.1 The Otsuka study did not measure Environmental Tobacco Smoke, it measured only Carbon Monoxide (see page 1, left half, of Otsuka abstract) published by the Journal of the American Medical Association, Vol 286;286:436-441). Can the same symptoms be induced by standing beside the exhaust of a city of a city bus?

1.2 The Ostuka study was the subject of peer review criticism because it did not measure ETS and gave no information about associated ventilation systems (see page 1, right half, of Otsuka abstract.)

1.3 Moreover, peer review of the Otsuka study stated "In terms of public policy, it would be useful to know how typical these exposures and results are." Readers should note that the State of Washington and other states have not conducted any credible study of actual ETS exposures. Indeed, Washington has refused to conduct such studies or participate in ETS exposure studies as far back as 1994 regarding a Redmond, Washington business and as recently as June 2003 in Pierce County (see June 24, 2003 E-Mail correspondence between "Secondhand Smoke Consultant" James Repace and Tacoma-Pierce County Department of Health staff member John Britt).

1.4 The story about the Otsuka study goes even deeper when considering the actual data published (see page 438 of the JAMA publication) for the full text of Otsuka). The results for Carbon Monoxide in my company's 1994 ETS study show an eight hour time-weighted average Carbon Monoxide mean exposure of 1.7 parts per million (ppm) and a range of 0.9 to 2.0 ppm with smoking permitted at work stations (see data table on third page of HPAC.PDF, which is page 78 of the publication.) The corresponding outdoor Carbon Monoxide concentrations measured at the same time were a mean of 2.8 with a range of 1.9 to 3.5. The data for our company were also consistent with Carbon Monoxide exposures measured in six other Washington office buildings at or about the time. Otsuka, data however, show that the 30 study participants were taken from a nonsmoking area with a mere 0.40 parts per million Carbon Monoxide and immediately placed in a smoking room with 6.02 parts per million concentration of Carbon Monoxide (an immediate increase of 15 times the previous exposure.) The material points about that data are:

a.) The Carbon Monoxide concentrations reported in the Otsuka study are at wild variance with typical work place exposures as actually measured in Washington work sites. This emphasizes peer review comments about the Otsuka study published by JAMA "In terms of public policy, it would be useful to know how typical these exposures and results are." 

b.) The extreme ranges of Carbon Monoxide levels in Ostuka for nonsmoking and smoking areas are not only atypical of actual exposures but those ranges could also be severe enough to induce cardiac symptoms reported based exclusively on changes in CO exposures and independent of any consideration of ETS. 

The failure to measure ETS exposure by University of Washington study authors was discussed in item 4. of the section titled "Pregnancy and Smoking" in the first work of this series published by July 6, 2007, Big Drugs, Pregnancy and Social Marketing. In the case of this study not only was ETS exposure never measured but a numeric plug-figure was included in the calculations by the authors that attributed occasional firsthand smoking to pregnant mothers in the "2nd Hand Smoke Exposure" participant group.  

Yet, as with the Otsuka study, we find the certainty of an established causal relationship being created in the public mind where no such relationship can be proven or does exist. Unfortunately, peer review comments equivalent to those that openly questioned the methods and findings of the Otsuka study concerning heart disease are not presently available for the University of Washington research about prenatal exposure to ETS. 

Finally, those who read the interview questions and Ms. Kopp's responses will note that she references the 2006 report of the U.S. Surgeon General, "The Health Consequences of  Involuntary Exposure to Tobacco Smoke," on several occasions. Similar to the Otsuka study, serious questions regarding the 2006 surgeon general's report and conclusions were presented in a subsequent issue of the Journal of the American Medical Association (JAMA). See JAMA, "Report Reviews Secondhand Smoke Risks," by Bridget M. Kuehn:

"At a June 27 press briefing launching his new report on the ill effects of secondhand smoke, Surgeon General Richard H. Carmona declared that 'the debate is over.' But some scientists continue to question the magnitude and immediacy of cardiovascular and lung cancer risks attributed to secondhand smoke exposure."

See also, "JAMA Article Brings Surgeon General's Misrepresentation of Secondhand Smoke Science to the Forefront"  by Dr. Michael Siegel, a noted tobacco control advocate:


"An article in the current issue of JAMA (Journal of the American Medical Association), reporting on the recent Surgeon General's review of the health effects of secondhand smoke, brings to the forefront the controversy over whether the Surgeon General misrepresented the science in his public communications surrounding the report's release (see: Kuehn BM. Report reviews secondhand smoke risks: some scientists question risk level. JAMA 2006; 296:922-923). The controversy stems from the press release and other ancillary materials released by the Surgeon General to accompany the report itself. . . . In other words, it appears that CDC agrees that it is preposterous to assert that a brief exposure poses any problem for a person who does not have severe coronary artery stenosis to begin with, and CDC is unwilling to defend the Surgeon General's misleading claims. At the same time, CDC is also apparently unwilling to suggest outright that the Surgeon General went too far in his press release, remarks, fact sheet, and brochure."   

Suffice it to say that those who apply the 2006 U.S. Surgeon General's report about involuntary exposure to tobacco smoke to support smoking bans face a daunting task. It is deeply disappointing that Ms. Kopp refers to the recent surgeon general's report about involuntary exposure to tobacco smoke to buttress the claims made in her study and the press about the effects of prenatal exposure to ETS. One reasonably presumes that competent researchers would be aware of the great controversy among medical doctors and disease prevention specialists that report has justifiably inspired.  

A pattern of conduct becomes apparent from the above JAMA reports concerning the Otsuka study, the surgeon general's report, and the University of Washington research: studies that do not prove what is claimed are accepted as proof of the claims, and then used by mainstream media press to create a certainty of risk in the minds of the general public to support predetermined public policy.  

2.0 Uncertain Causation, Absolutely Certain Effects 

There is considerable and reasonable doubt that ETS presents the health risks as represented by tobacco control advocates. There is, however, no longer any material question about the adverse impacts that smoking bans have on many independent small business owners and their employees. Through examining the now-well-documented adverse effects of smoking bans on the hospitality trade we directly confront a question: "At what cost others is special-interest smoking ban policy advanced?" 


From the State of Washington, Department of Revenue June 11, 2007 press release, "Smoking Ban Has Minimal Effect on Overall Income of Bars, Taverns," quoting DOR spokesman Mike Gowrylow:


"OLYMPIA, Wash., June 11, 2007 - The Initiative 901 smoking ban that began in December 2005 appears to have had minimal effect on the overall income of bars and taverns. Their gross business income increased 0.3 percent during 2006, compared to 1.1 percent average annual growth from 2002 through 2005. While income from gambling activities declined, it was offset by growth in taxable retail sales of food and drink.  Taxable sales grew 3.6 percent in 2006, compared to 2.1 percent average annual retail sales growth for 2002 through 2005. Although the Department has not attempted to establish a cause-and-effect relationship between the ban and business revenues, the numbers suggest that bars and taverns may have lost some smokers, but gained customers drawn to a smoke-free environment.  While some drinking places may have been hard hit by the ban, overall the industry appears to have been able to adapt. The same couldn't be said for gambling establishments, whose gross income dropped 9.8 percent during 2006.  However, business income for this sector already was in recent decline, dropping 8.6 percent in 2004 and 5 percent in 2005 after a 19.5 percent gain in 2003. Restaurants didn't appear to be affected by the smoking ban because 80 percent of them already were smoke free before the ban took effect.  The taxable retail sales of full-service restaurants increased 9.1 percent in 2006, compared to 8.3 percent average growth for 2002 through 2005. " (Underline added.)


NOTE: WA DOR data are customarily for Fiscal Year ending June 30. If the above data are for fiscal year they are a year old. If for the 2006 calendar year they are six months old. Data cannot be for FY 2006-2007 because the last month data for June 2007 are not yet reported.


The Washington Department of Revenue data reveals a fundamental shift in the competitive structure of the hospitality trade. Restaurant revenues accelerated, previous increases in bar revenues reversed, there will be a corresponding reduction in tavern profits and increase in restaurant profits. Those facts set the framework for economic impact and damage analysis. My layman's view is that the press release also illustrates the power of the legal case that bars and taverns may have as to economic impact under federal workplace standards for economic feasibility.  

The Washington Department of Revenue press release is interesting because it illustrates how tobacco control and its state agency supporters spin the economic impact of smoking bans on bars into "positive news," which is in turn immediately distributed statewide through mainstream media news.  

2.1 Discussion of Washington Statistics. Consider the facts as presented by the Washington Department of Revenue: 

a.) Bar and tavern income increased 0.3 percent during 2006, compared to previous three-year average increases of 1.1 percent 2002 to 2005.


1. The rate of increase in income for bar and tavern income declined significantly from 1.1 percent per year to 0.3 percent in 2006.


2. Those figures represent a 72.7 percent decline in revenue growth compared to the preceding three-year average.


b.) In contrast, "taxable retail sales of full-service restaurants increased 9.1 percent in 2006, compared to 8.3 percent average growth for 2002 through 2005."


1. The rate of increase in income for restaurants accelerated from a previous three year average of 8.3 percent to 9.1 percent in 2006.


2. Those figures represent a 9.9 percent increase in 2006 taxable sales by restaurants compared to the preceding three year average.


c.) Restaurants are experiencing accelerated increases in sales while bars and taverns experience sharp decreases in sales growth, both compared to preceding three-year baseline.


1. However, restaurants tend to have a more diverse revenue base, which includes meal service and often alcoholic beverage sales.


2. Perhaps this explains why the Washington Restaurant Association (WRA) did not oppose Washington's I-901 in 2005. Their large franchise chain principal membership, 80 percent or more of which were smoke free as of 2005, benefits by taking customers from small neighborhood establishments that permit smoking.


d.) Please note the term "Taxable Retail Sales" is used by WA Department of Revenue for restaurants, whereas "Gross Business Income" is reported for bars.


1. While the terms may be similar, the vast majority of bar and tavern income would be from liquor sales. Conversely, for restaurants the majority of income would be from food.


2. The proper distinction would be to compare trends for liquor tax receipts from restaurants and for bars and taverns as two separate data items.


3. Failing to do so may hide a highly relevant fact: what if growth in liquor sales for restaurants that also serve alcoholic beverages are strongly increasing while those for bars and taverns are decreasing? That fact would also strongly support the case that smoking bans are employed by large franchise chains to take market share from small, neighborhood  independents. 


e.) For gaming establishments "gross income dropped 9.8 percent during 2006.  However, business income for this sector already was in recent decline, dropping 8.6 percent in 2004 and 5 percent in 2005 after a 19.5 percent gain in 2003."


1. Gross income for gaming establishments continued to decline for three consecutive years.


2. It appears that previous moderation of the decline has reversed, with the greatest decline in revenues (-9.8%) for the past three years occurring in 2006.


2.2 Consider the above information in light of the February 12, 2007 report by the President's Council of Economic Advisers and

a.) Real Gross Domestic Product (GDP) increased 3.4 percent in 2006. Restaurants are experiencing increases in revenues (9.1%) vastly greater (267 percent) greater than GDP, while bars and taverns are experiencing revenue increases (0.3%) a mere fraction of GDP (8.8%).


1. Considering that in Washington 80 percent of restaurants were already smoke free at the time I-901 passed in November 2005, this statistic could be extremely important as a measure of the true adverse impact of smoking bans.


2. Bars and taverns are falling more and more behind growth in the national economy while restaurants are accelerating ahead of overall economic growth.


b.) reports that as of June 15, 2007 the current inflation rate is 2.69%.


1. Washington restaurant revenues show strong increases in profitability compared to inflation (profits increase of 9.1% are more than three times the inflation rate and growing.)


2. However, bars and taverns profit increase of a mere 0.3 percent put them at a scant ten percent of the current inflation rate.


3. Again there is are clear indications that bars and taverns are falling well behind restaurants, failing to keep up with inflation.


c.) Contrary to claims by the state department of revenue and tobacco control advocates, there are clear economic indicators that Washington bars and taverns are particularly hard hit by the state's smoking ban that became effective in January of 2006.


2.3 Current News in Perspective: Consider what mainstream media has said in Washington about impact of smoking bans on bars and taverns in August of last year and recently about the Department of Revenue's latest press release.  

a.) From the Seattle Post-Intelligencer, August 18, 2006, "Smoking Ban a Drag on Bar Take?"  by Mike Lewis:


It didn't take state bean counters in Olympia to tell Nitelite bartender Tobi Hower everything she has seen with her own two eyes since the state banned bar smoking: fewer customers. Newly irregular regulars. Booze's pull losing ground to nicotine's grip. 'Yeah, business is down,' said Hower, 30, who tends bar each week at both Nitelite in Belltown and the Little Red Hen in Green Lake. 'It's the same at both places. Our regulars don't come by and don't stay as long when they do. I'm really bummed.' State tax revenue trends verify what Hower and other mixologists are seeing since January and the passage of Initiative 901, which banned smoking in bars and restaurants. Sales revenue from bars in the first three quarters of 2006 dropped 3.4 percent, or $122 million, from the same period in 2005. That year, before the ban, revenues had risen 4.3 percent from the prior 12 months. State officials, however, say it is too early to say with certainty that the decline exclusively resulted from the ban. Over the same period restaurant revenue is up, state numbers also show. 'Year to year, the bar industry is volatile,' said Mike Gowrylow, a spokesman for the Department of Revenue. 'So is it the smoking ban? We don't know that yet.'" (Underline added.)


b.) It appears that Mr. Gowrylow has divined the answer to his August 18, 2006 question, "So is it the smoking ban?" From the Seattle Post-Intelligencer, June 13, 2007, "Eateries, Bars Doing Fine After Smoking Ban," by P-I News Services:


"OLYMPIA -- Gambling declined while beer and food sales rose slightly in bars, restaurants and gambling establishments across Washington last year, the first full year under a smoking ban, state figures indicate. Alcohol and food sales were 3.6 percent higher in 2006, compared to a 2.1 percent average annual growth rate in 2002-05. Gross income at non-tribal gambling businesses was down by 9.8 percent in 2006, according to Revenue Department figures issued Monday. 'The numbers suggest that bars and taverns may have lost some smokers but gained customers drawn to a smoke-free environment,' department spokesman Mike Gowrylow said. "The numbers suggest that bars and taverns may have lost some smokers but gained customers drawn to a smoke-free environment," department spokesman Mike Gowrylow said. Under an initiative approved in November 2005, smoking is banned in bars and restaurants and within 25 feet of the doors and windows of businesses. Tim Tweten, who owns six restaurants in the South Puget Sound area, said he appreciates the ban but isn't sure it has anything to do with his alcohol and food sales exceeding the state average. Gowrylow said it was unclear whether the drop at non-tribal gambling businesses was because of smokers turning to tribal casinos, which are exempt from the smoking ban." (Underline added."


c.) The Seattle Times lead the good news from tobacco control to bar and tavern owners with a similar article on June 12, 2007, "Alcohol, Food Sales Rise With Smoking Ban in Washington Eateries," from the Associated Press.  

2.4 We progress from August 18, 2006 to June 11, 2007 through an interesting, curious and deeply troubling set of facts.  

a.) Economic impact of smoking bans that was feigned as "unknown" in August of 2006 is now declared with certainty to be positive in June of 2007, despite observations that the facts reported by the Washington Department of Revenue prove the opposite.


b.) The allegedly positive impact is reported in the precise context of tobacco control claims that were used to sell Washington's I-901 statewide smoking ban initiative to voters in late 2005: "'The numbers suggest that bars and taverns may have lost some smokers but gained customers drawn to a smoke-free environment,' said Mike Gowrylow, a spokesman for the Department of Revenue.


c.) The tobacco control Social Marketing theme that smoking bans good for business is touted once again, despite a fundamental change to the competitive structure of the hospitality trade that increases restaurant revenues and profits and decreases bar and tavern revenue and profits.


d.) In-depth analysis of restaurant and tavern revenues in other states reveals that this is a consistent pattern.  

2.5 Nationwide, The National Restaurant Association NRA page on smoking also features a link to an insightful 2004 research report, Impact of Smoking Ordinances on Restaurants published by That report is well worth reading because it provides some rather striking information about restaurants that have a large customer base of patrons who smoke. The data reported strongly suggest that large franchise chain restaurants that are "Smoke Free" by policy experience minimal impact from smoking bans, whereas small independent restaurants that have a patron base that includes smokers suffer considerable revenue declines.  

a.) That 2004 NRA report says, in part: 



The restaurant industry remains an industry of choice. Restaurant operators, like most Americans, want to be free to make their own choices-choices that are best for them, their employees and their customers. Restaurant operators should be able to choose a smoking policy that works best for them and their patrons, both non-smokers and smokers, free of "one-size-fits-all" mandates by government. For some restaurants, this means being able to declare their establishments smoke-free, if that's what customer demand dictates. On the other hand, many others have substantial numbers of smoking customers whom they must continue to be able to accommodate or significant business will be lost. The restaurant industry is here to serve our customers-non-smokers and smokers alike. (Underline added.)




Yes, some restaurants have experienced lost sales as a direct result of strictest of smoking bans. According to the study, restaurant sales decline more than 50 percent when counties implement 100 percent smoking bans that include both the dining and bar areas. With smoking banned completely in the entire restaurant, total annual sales declined an estimated 55.2 percent within a year's time in some restaurants. (Underline added.)


š Restaurant sales decline when counties implement 100 percent smoking bans (excluding the bar area). Total annual sales declined an estimated 49 percent at restaurants where such bans were enacted two to three years prior to the survey.


š Restaurant sales decline when cities/towns implement 100 percent smoking bans (excluding the bar area). Annual sales declines were estimated at 36 percent at restaurants where these bans were enacted four or more years earlier. 

b.) Despite such reports, many state restaurant associations support or do not oppose smoking bans. The Washington Restaurant Association did not oppose I-901, which passed a statewide smoking ban for nontribal hospitality establishments. Private clubs like veterans organizations did not oppose I-901 because believed they were exempt. The American Legion's lawsuit to oppose I-901 enforcement after the ban passed is now on appeal to higher courts.  

c.) Similarly, in Colorado The Colorado Restaurant Association (CRA) 2007 Member Impact Survey Web Page publishes the following statement about smoking bans: 

"The impact survey shows increasing support for a statewide smoking ban. When asked in this recent poll, 61% of member participants were in favor of such a ban. That is up from 56% in late 2004, 46% in 2003, and 39% in 2002."  

d.) In Ohio the Veterans of Foreign Wars (VFW) recommended that its members vote for statewide smoking ban Issue 5 because the private club organization believed it would be exempt but enforcement was undertaken against private clubs after the ban passed. 

e.) How does one reconcile's above statements about steep revenue declines in restaurant revenues with the expressed support for smoking bans by many restaurant association members? One response is to look at it from the viewpoint of an expensive, upscale large franchise chain that is already "Smoke Free" by choice.  

1. We know that the current aggressive push for smoking bans from tobacco control advocates financed by a private foundation directly associated with pharmaceutical Nicotine Replacement Therapy (NRT) manufacturers and distributors is increasing public awareness of anti-tobacco claims about the alleged risks of exposure to Environmental Tobacco Smoke (ETS). The fact that most of the claims are wildly exaggerated and demonstrably false does not change the public belief impact of such advocacy.


2. According to tobacco control "statistics," we know that persons who smoke are predominantly in the middle and lower income brackets, with a relatively small percentage of high income professionals who smoke.


3. We know that a restaurant with an upper middle to high income customer base would be more likely to experience customer demands for "Smoke Free" environments than a diner next to an industrial center. Economic impact of smoking bans is therefore felt in direct proportion to the customer base who smokes.


4. We also know that an large franchise chain restaurant that is already "Smoke Free" by choice can reasonably anticipate positive revenue results from a statewide smoking ban.


5. We also know that the most bars and taverns have disproportionately higher percentages of patrons who smoke. In addition, the market and patron dynamics of the bar and tavern trade are vastly different compared that of full service restaurants. Principally, patrons who don't mind not smoking during a 30 minute to one hour seating at a restaurant to eat a meal can become quite upset about being prohibited from smoking during a one to three hour stay in a bar where they also intend to drink alcoholic beverages.  Having a smoke with a meal is one thing, being prohibited from enjoying a smoke with beer in a bar is entirely another.


6. The minimal, if any, financial impact from a smoking ban for voluntarily "Smoke Free" large franchise chain full service restaurants, in light of the NACIS code descriptions above, also becomes a market share opportunity. They preserve their nonsmoker patron base while enjoying additional patronage from customers who no longer have a choice about smoking in any restaurant, bar or tavern. The impact of that opportunity is felt and observed in revenue statistics such as those in Washington. 

The bottom line is that, beyond providing direct mercantile support for pharmaceutical Nicotine Replacement Therapy products, smoking bans are now employed as a competitive weapon in restaurant's quest for expanded market share. Small, independent bar and tavern owners, as well as their employees are caught in a well-crafted bind to squeeze them out of the hospitality market.  

So are large franchise chain restaurants responsible corporate citizens who are looking out for the public health, while bar and tavern owners are irresponsible miscreants who exposure their pregnant employees to hazardous substances that will harm unborn children? Of course not. Both are business people looking for a return on their investment and seeking optimum profits. Large franchise chain and upscale restaurants simply seek to do so in part by seizing the advantage of supporting alleged public health regulations that predictably reduce market share for smaller, independent hospitality trade establishments. As with most things in the current political era, increased political clout and acquiescence to special-interest agendas equals increased profits. Moreover, large franchise chains have the political lobbying wherewithal to know which the research studies will direct public opinion winds of the day.  

The University of Washington study concerning pre-natal exposure to tobacco smoke and its alleged adverse consequences on fetal development and child behavior problems therefore becomes just one small anti-competitive cog in an ever-expanding wheel that concentrates revenues and profits into fewer and hands at "Target" consumer's, tax payer's, and small, independent business owner's expense. That such actions are undertaken with the support of studies that do not prove what some authors and mainstream media claim is axiomatic: independent, credible scientific inquiry cannot predictably create the profit-making effect desired.  

Now put yourself in the position of owning a small neighborhood tavern. How would you feel about having the value of your investment of capital and years of elbow grease diminished and your livelihood in effect stolen by university researchers in hot pursuit of mental health grants?  

3.0 Workplace Standards Substitution

How is the now-predictable impact of smoking bans on small, independent hospitality trade establishments achieved? At its core it's a very simple process: substitute private special-interest mercantile policy for well-established federal regulatory standards. Funding a few million in special-interest grants to develop the Social Marketing themes that support that effort is buying market share, and competitor's revenue streams on the cheap; a few years of research grants is a very small price to pay for enhanced profits that will last for decades after small competitors are driven out of the market.  

The above stated position by Ms. Kopp - to eliminate suspected, potential risk -  is a de minimis risk policy. De minimis risk is that which under reasonably foreseeable circumstances could result in any possibility of injury. That policy is in direct contrast with a material risk standard, which establishes Permissible Exposure Limits (PELs) believed to prevent serious injury or death under established workplace conditions. The federal workplace standard applied by the U.S. Occupational Safety and Health Administration (OSHA) is material risk.  

The difference between de minimis risk policy and material risk standards is defined in terms of economic feasibility. OSHA considers at least three criteria for economic feasibility: 

3.1 Industry or sector economic impact greater than 1 percent of annual revenues.

3.2 Industry or sector economic impact greater than 10 percent of annual profits.

3.3 Material change in competitive structure of the industry or sector affected. 

Department of Revenue statistics for Washington and other states establish that smoking bans impose economic consequences that violate each of the three above standards. Tobacco control policy therefore promotes smoking bans in violation of well-established and legally enforceable workplace health and safety standards.  

The fundamental choice therefore becomes do university researchers and health policy advocates ultimately come to respect and accept federal workplace health and safety standards or will they continue to promote self-serving legislation in defiance of those standards? 

The above also presents a personal choice for we the people: by what standards to we choose to govern ourselves as a people? 

Closing Comments 


From the University of Washington Department of Psychology Fact Sheet, accessed July 7, 2007: 

Fiscal Information

Total expenditures for 2001-2002: $13,680,015.

Grant expenditures: $7,396,301.

State expenditures: $5,493,371.

Local expenditures $790,343. 

As stated in the first commentary in this series, the University of Washington's study concerning prenatal exposure to ETS and child behavior problems was funded by a grant from the National Institute of Mental Health. From the above report is appears that $7,396,301 of the university's psychology department $13,680,015 budget (58.0 percent) is dependent on grants. Along with those grants comes the political and/or mercantile agenda of the grantor.  

One aspect of tobacco control's mercantile agenda is particularly troublesome ad alarming. That aspect has been an integral part of tobacco control policy for more than fifteen years. It was published April 1993 in "Planning for a Tobacco-Free Washington" under federal contract for the $135 million George H.W. Bush Administration's 1991 to 1998 Project ASSIST (see TFW22.PDF).

Principles: To "Target" specific populations.

Strategy: ". . . the most effective way to reduce smoking rates is to decrease public tolerance of tobacco use."

Policy: "Changing public acceptance of tobacco use will require policy change, a critical ingredient of societal change." Its policies include:     

Increasing the price of tobacco products.
Increasing the number of smoke-free environments.

Media: "Social change requires that people receive persistent and consistent messages from sources they trust. To this end ASSIST resources will be use to generate a variety of media messages that will foster and strengthen public support for proposed policy changes."

The University of Washington study concerning prenatal exposure to ETS and later childe behavioral problems is clearly being used to negatively label persons who smoke as a direct threat to the well-being of babies in the womb and to unfavorably stereotype them as a hazard to society. The study is so employed to directly support tobacco control advocacy political objectives to expand smoking bans in apartment residences and workplaces such as bars and restaurants. There is a direct economic tie between tobacco control advocates and pharmaceutical nicotine special interests through a half billion dollars in anti-tobacco grants. Moreover the study clearly demonstrates the integration of mental health and anti-tobacco, as set forth in S.1074 during the 1109th Congress. Finally, the explicit participation of mainstream media in promoting as true "facts" that sturdy authors deny is apparent.  

It comes down to do we the people govern ourselves by Junk Science studies being aggressively employed through media in a nationwide propaganda campaign to reduce public tolerance of select "Target Groups," or do we aspire to higher ideals? Of equal importance, we must decide as a people how long will we continue to bear the costs of public policy being employed to manipulate regulatory standards for mercantile gain. 

It is worth noting that similar unseemly media tactics have been employed in the past to prove the allegedly compelling need to exclude Jews from swimming pools for "health reasons," to justify separate drinking fountains for black persons because they "spread germs," and to advance the cause of eugenics through forced sterilization of those with disabilities or mental illness and who therefore had "lives not worth living." To my mind, such tactics were as filthy then as they are today. It appears to be a vain hope that either academic researchers or mainstream media can incorporate cultural sensitivity or common decency into conclusions reported from studies-on-demand to support tobacco control advocacy. One profoundly hopes that at some point in the future humankind will sufficiently advance its growth in spirit to the tactics of intolerance and hate cannot continue to be successfully employed. 

It appears to me that grant funded university research could be a very good place to begin turning things around.  

Norman E. Kjono








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