Ever since scientific evidence in terms of environmental tobacco smoke (ETS) or second hand smoke (SHS) has conclusively linked passive smoking and disease or death, the tobacco industry has tried denying them. Exposure to SHS is known to cause ear infections, bronchitis, pneumonia, asthma, lung cancer, and heart attacks, increase the risk of miscarriage, premature birth and also cause Sudden Infant Death Syndrome in children. In Japan, the 1981 Hirayama spousal study examined the linkages between passive smoking and lung cancer among non-smoking wives of smokers. It concluded that wives of heavy smokers were two times more at a risk of developing lung cancer when compared to wives of non-smokers. The study was influential because of the amount of debate it generated and has been quoted during the setting of regulatory proceedings and risk assessments against the tobacco industry. Several strategies were created by the tobacco industry to actually disclaim and refute such studies. The spousal study was refuted by the tobacco industry which conducted its own independent research. This independent study was done by the Center for Indoor Air Research, Japan, which is supported by the tobacco industry. The study directly refutes claims about SHS causing any health impacts. It says no evidence was found to link SHS to increased risk of lung cancer and disclaims the Hirayama spousal study as having no scientific basis at all. Consultants who took part in the study were all related to the tobacco industry.

The PAO report titled "Profits over people" shows similar strategies being carried out in the LAC region. Consultants were commissioned to produce reports that questioned the scientific evidence about passive smoking and ill-health. Symposia were held so that journalists would view the tobacco industry favourably. When it came to advertising, the industry while promoting youth smoking prevention strategies, simultaneously also ran youth targeted cigarette-advertising campaigns, thus adopting a dual marketing policy.

Another interesting paid evidence given out by the consultants was in terms of shifting the debate to indoor air quality. The objective here was to convince the public that SHS was just a minor contributor to indoor air pollution since both indoor and outdoor air already have many other contaminants present.

A total of 40 million people die every year due to tobacco. As the number of deaths continue to rise, it is the developing countries with its ill equipped social infrastructure, which will face this terrible health burden.

These two reports show how human health is of no consequence when it comes to money-making, and how smoking is being termed as a socially acceptable phenomena so that the industry can eventually escape regulatory and legislative constraints.