Secondhand smoke poses serious health risks to nonsmokers Each year thousands of innocent nonsmokers suffer needlessly from secondhand smoke-the smoke exhaled by smokers and the smoke that comes from the burning end of a cigarette, pipe or cigar. According to the U.S. Environmental Protection Agency (EPA), secondhand smoke "is responsible for" 3,000 lung cancer deaths among non-smoking Americans each year. Secondhand smoke also accounts for as many as 62,000 deaths from coronary heart disease in the United States annually. Studies rank secondhand smoke as the third-leading cause of preventable death in the United States.

Secondhand smoke, also known as environmental tobacco smoke or passive smoke, is so dangerous because it contains more than 4,000 chemicals, including more than 50 cancer-causing agents and 200 poisons. Chemicals found in secondhand smoke include acetone, arsenic, ammonia, benzene, carbon monoxide, asbestos and formaldehyde. The EPA lists secondhand smoke as a Group A carcinogen, a rating used only for substances proven to cause cancer in humans.

The health risks associated with secondhand smoke pose a threat to the vast majority of Americans. Nearly 90 percent of nonsmoking Americans are exposed to secondhand smoke as measured by the levels of cotinine in their blood. The presence of cotinine, a chemical the body metabolizes from nicotine, indicates that a person has been exposed to tobacco smoke.

According to medical research, exposure to secondhand smoke causes a number of illnesses in nonsmokers including cancer, heart disease, respiratory problems and reproductive problems.

Young children and babies still in utero are most at risk from secondhand smoke, and the elderly also are particularly vulnerable," said Dr. Richard Hurt, director of nicotine dependence programs at the Mayo Clinic in Rochester, Minn. "In infants, secondhand smoke causes sudden infant death syndrome (SIDS), asthma and inner ear infections. Infants also lack the ability to move away from smoke."

Secondhand smoke increases the frequency of episodes and severity of symptoms in an estimated 200,000 to 1 million asthmatic children. It also increases the risk of asthma in children who have not previously displayed asthma symptoms.

The workplace is a source of repeated secondhand smoke exposure, and studies demonstrate that the increase in lung cancer risk from workplace secondhand smoke exposure is about the same as from household exposure. Secondhand smoke exposure in the workplace also contributes to the aggravation of asthma in adults.

Workers in the hospitality industry are at high risk because the nature of their workplace often demands prolonged exposure to secondhand smoke. One study showed bar and restaurant workers exposed to secondhand smoke had cotinine levels that were five and a half times as high as for other workers not exposed to secondhand smoke.

Thanks to research and a greater understanding of the depth of health problems caused by secondhand smoke, efforts are growing nationwide to limit exposure to secondhand smoke in public areas and workplaces. Public health boards and legislators are working at the local, city and county level to safeguard public health by banning smoking in these areas.

These efforts to limit secondhand smoke have produced the following results:

• More than 220 cities nationwide have banned workplace smoking.
• Smoking in restaurants has been banned in 300 cities.
• More than 1,000 cities have enacted local clean indoor air laws. (Some of these cities have exemptions for smoking in separate, enclosed spaces.)

Those opposed to smoking bans in restaurants have argued that such bans will hurt those businesses. However, there has been no negative economic impact on restaurants due to smoking bans, according to Jeremy Hanson, advocacy director for the Minnesota Smoke-Free Coalition. Studies that examine economic data such as sales tax receipts, income and employment, show that smoke-free ordinances don't hurt a restaurant's bottom line. In addition, restaurant and bar employees showed dramatic improvement in pulmonary lung function tests within weeks of smoking bans taking effect. Having public places that are smoke-free also helps smokers who are trying to quit.

"There is no safe, lower limit exposure to secondhand smoke that is without risk," said Dr. Hurt. "To reduce exposure to secondhand smoke, avoid being in an enclosed area where people are smoking, such as a car or room."

--Published August 20, 2001