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Almost five years after the tobacco industry agreed to pay $300 million to start a research foundation in order to settle a landmark lawsuit brought on behalf of thousands of flight attendants, the new Flight Attendant Medical Research Institute has selected its first grant recipients. FAMRI, a nonprofit foundation, was created as part of the 1997 settlement between flight attendants and tobacco companies to study smoking-related illnesses. In the coming weeks, it is expected to fund 38 grants totaling $20 million to both individuals and organizations. “Tobacco companies are merchants of death and disease,” said attorney and FAMRI board member John Ostrow. “Our aim is to sponsor medical research to attack the maladies caused by exposure to cigarette smoke.” Recipients include the Environmental Tobacco Smoke Center of Excellence at the University of California, San Francisco, the Harvard University School of Public Health and Dr. Xingming Deng at the University of Florida Shands Cancer Center. Grants range in duration from two to five years. FAMRI held its inaugural meeting with the grant recipients last month at the Hotel Inter-Continental in downtown Miami. In 1991, Norma Broin, an American Airlines flight attendant, filed a class action lawsuit against the tobacco industry in Florida’s Miami-Dade Circuit Court on behalf of nonsmoking flight attendants who suffer from smoking-related illnesses. She alleged that cigarette makers such as Philip Morris, RJ Reynolds, Lorillard Tobacco Co., Liggett Group, Brown & Williamson and British American Tobacco should be held liable for second-hand smoke inhaled by the attendants while they toiled aboard airplanes. A flight attendant for more than two decades, Broin was diagnosed in 1989 with lung cancer even though she had never smoked. Smoking was not banned on domestic flights until 1990. Broin, along with thousands of flight attendants, sought $5 billion in damages. The trial proved to be a conflict-ridden contest characterized by frequent objections and sidebars, and a frustrated judge who constantly warned attorneys on both sides to behave themselves and cut down on the rhetoric. In October 1997 cigarette makers settled with the flight attendants for $349 million. The settlement was criticized in some quarters because $300 million was given to the newly created foundation and $49 million in fees and expenses to Stanley and Susan Rosenblatt, the attorneys representing the flight attendants. No money was awarded to the flight attendants themselves. Others defended the settlement on grounds that the agreement makes it easier for flight attendants to sue individually. The agreement allows flight attendants to file lawsuits regardless of the statute of limitations. It also shifts the burden of proof to the tobacco industry, and flight attendants are allowed to seek noneconomic damages such as pain and suffering. To date, hundreds of individual lawsuits have been filed, but no flight attendant has won at trial or has settled with cigarette makers. Stanley Rosenblatt, who serves as chairman of the FAMRI board of trustees, referred questions to other board members. Since the settlement, FAMRI has largely worked in obscurity. Just last month the organization set up a Web site, and it was not until last September that the organization opened an office in Miami. At the same time, the foundation named a full-time executive director, Elizabeth Kress, who oversees day-to-day operations from a 13th floor office in the Miami Center downtown on Biscayne Bay. Ostrow said the board has consistently worked to build the foundation. Since the settlement, board members have met regularly. He said the process has been arduous: “If you are not involved, you have no great appreciation for the complexity of it all.” “There has been a period of learning how to create a foundation,” added Kress. “We have learned as we have gone along.” FAMRI is controlled by the seven-member board of trustees that was appointed by Miami-Dade Circuit Judge Robert Kaye, who presided over the Broin case. The board comprises Stanley and Susan Rosenblatt, Ostrow and four flight attendants from American and United airlines who reside in California and Texas. Ostrow, a personal injury and federal copyright attorney in Miami, became involved in the case when Judge Kaye appointed him to represent flight attendants not represented in the class action. Some flight attendants chose to opt out of the class, did not register with the class action or did not qualify. Later, Judge Kaye broadened Ostrow’s role, appointing him as special master to monitor the tobacco companies’ payments and oversee the establishment of the foundation. Finally, the judge appointed Ostrow to the board. Kress said FAMRI’s mission is to sponsor medical research for the early detection, prevention and cure of tobacco-related illnesses. She said FAMRI is already making an impact: “At our inaugural meeting last month with the scientists, a waiter at the hotel told me he was going to quit smoking. That is the impact we are going to have.” The board of trustees, Ostrow said, receives counsel from a six-member medical advisory board and a seven-member lay advisory board. The medical board includes Julius B. Richmond, a former U.S. surgeon general who is a professor emeritus at Harvard Medical School. The board of trustees is responsible for investing the $300 million, hiring and deciding what smoking-related diseases to study. Ostrow said the board members did not want to rely entirely on the medical advisory board and spent a considerable amount of time researching smoking-related illnesses. Asked why it had taken so long for the committee to issue grants, he said the grant-making process itself takes over a year. “The whole thing involved lots of time: What stocks to buy? What bonds? Who advises you? What diseases are we going to attack? Answering these questions all takes a lot of time,” said Ostrow. Trustees are not paid a salary. They receive a small stipend for serving on the board and participating in the day-long, once a month meetings, said Ostrow, who said that for his work on the Broin case he was paid an hourly fee by the Rosenblatts from the money they received in the settlement. FAMRI hired Washington, D.C.-based American Institute of Biological Sciences to review grant applications and hired St. Louis-based Hammond & Associates for investment advice. FAMRI has used three banks: Mellon United National Bank, SunTrust and Northern Trust. According to Ostrow, the board has managed to expand FAMRI’s assets despite the steep downturn in the securities markets over the past two years. He said FAMRI has more money now than it did when it started. He declined to disclose an amount. Not surprisingly, Ostrow said FAMRI does not invest in any tobacco stocks or even in mutual funds that maintain separate investments in tobacco companies. The board is currently preparing to send out requests for proposals for next year. One of the questions that board has not resolved, said Ostrow, is the long-term plan for FAMRI. In particular, the board has not decided how long FAMRI will remain in existence. “We have been so busy with other stuff that we have not gotten around to deciding on the long-term view,” he said. “We haven’t decided if it will run in perpetuity or have a finite existence.” FLIGHT ATTENDANT MEDICAL RESEARCH INSTITUTE BOARD OF TRUSTEES Stanley Rosenblatt, chair Susan Rosenblatt John Ostrow Bland Lane, Sonoma, Calif. Lani Blissard, El Granada, Calif. Lisa Sudderth, Dallas Patty Young, Dallas FAMRI MEDICAL ADVISORY BOARD Julius B. Richmond, M.D., professor emeritus, Harvard Medical School Michael Cummings, Ph.D., chair, Department of Cancer Prevention, Roswell Park Cancer Institute, Buffalo, N.Y. Jerry Goodwin, M.D., director, Sylvester Comprehensive Cancer Center, University of Miami William Grossman, M.D., chief of cardiology, University of California, San Francisco Eloise Harmon, M.D., Shands Hospital at the University of Florida David Sidranksy, M.D., director, Head and Neck Cancer Research, Johns Hopkins Medical Institute, Baltimore, Md.

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