The tobacco industry and secondhand smoke: lessons from Central and South America.

For more than 20 years the tobacco industry has considered secondhand smoke to be a threat to its viability. In this article, we describe why secondhand smoke is important to tobacco control and how the tobacco industry's "Latin Project" sought to prevent the creation of smoke-free workplaces and public places in Central and South America. Eliminating secondhand smoke exposure not only reduces the risk of cardiovascular and other diseases, but also creates an environment that substantially reduces smoking and cigarette consumption among smokers. The "Latin Project" was initiated in 1991 by Philip Morris and British American Tobacco and managed by the law firm Covington & Burling. The project assembled a network of well-placed physicians and scientists to divert the attention away from secondhand smoke toward other indoor air pollutants. As proven in Central and South America, the tobacco industry has manipulated the secondhand smoke issue in order to avoid the development of smoke-free environments. Sub-Saharan Africa, facing an epidemiologic transition similar to the one experienced by Central and South America, should be aware of tobacco industry tactics. Further delay in implementing smoke-free environments will only increase the burden of cardiovascular disease in both areas of the world.