Health Effects of Secondhand Smoke (Environmental Tobacco Smoke)

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Health Effects of Secondhand Smoke
(Environmental Tobacco Smoke)
Christopher Squier Department of Oral
Pathology, University of Iowa, Iowa City, USA
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Secondhand Smoke why is it harmful?
Sidestream (secondhand) smoke has been shown to
be more carcinogenic than mainstream smoke
(Ninth Report on Carcinogens, U.S. Department of
Health and Human Services Public Health Service
National Toxicology Program 2001)
You dont get the benefit of the filter!
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Secondhand Smoke why is it harmful? Because of
where it goes
Into your lungs and then into your bloodstream
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Health Effects of Secondhand SmokeHeart Disease-
37,000 deaths per year

• 30 minutes of exposure to second-hand smoke
• resulted in reduced ability of the heart
  arteries
• to dilate in nonsmokers.
• Other effects include increased stickiness of
  vessel
• walls and increased clotting
• (Acute Effects of Passive Smoking on the Coronary
  Circulation
• in Healthy Young Adults Otsuka, et al.,
• J Am Med Assoc , July 2001)

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Health Effects of Secondhand SmokeThe paradox of
cardiovascular disease

• The relative risk of myocardial infarction
  (heart attack) in a non-smoker exposed regularly
  to secondhand smoke (0.2 cigarettes per day) is
  1.3 (i.e. 30 over no exposure)
• The relative risk of myocardial infarction (heart
  attack) in a pack a day smoker
  is 1.7 (i.e.70 over no exposure)
• Why are the risks so similar when the exposure
  is so
  different?
• This must be junk science!

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Health Effects of Secondhand SmokeCancer
15,700 deaths per year
a causal relationship between passive exposure
to tobacco smoke and human lung cancer
(Ninth Report on Carcinogens, U.S. Department of
Health and Human Services Public Health
Service National Toxicology Program 2001)

Iowa 400-700 per year
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Health Effects of Secondhand SmokeNot only
death but disease- and much of this affects
infants and children
Asthma 8,000-26,000
cases per year Bronchitis or Pneumonia
150,000- 300,000 cases per year Middle Ear
Infection 3.4 million cases per
year Sudden Infant Death Syndrome Low Birth Rate
Significantly Increased risk
Sources US Environmental Protection Agency 1992,
Respiratory Health Effects of Passive Smoking,
Washington DC Aligne et al. Tobacco and Children
1997, Arch Ped Adolesc Med 151,648 Sudden Infant
Death Syndrome Alliance, 1998
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Health Effects of Secondhand SmokeWhat is the
evidence?

• Evidence going back for over 25 years that
  secondhand smoke is a health hazard.
• Reports from agencies such as the National
  Academy of Sciences, the Surgeon General, the
  National Institutes of Health and from hundreds
  of refereed publications in scientific journals

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Health Effects of Secondhand SmokeWhat is the
evidence?

• Not only do we have evidence that secondhand
  smoke causes disease but also that if the
  exposure is removed there is a reduction in
  disease
• Data from California shows that within months
  after the prohibition of smoking in bars there
  was a significant reduction in respiratory
  disease among bartenders
• (Eisner et al., J Am Med Assoc 280, 1947, 1999)

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Health Effects of Secondhand SmokeWhat is the
evidence?Some recent data
Helena Montana
CDC Atlanta
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Reduced incidence of hospital admissions for
myocardial infarction associated with public
smoking ban before and after study. (Sargent,
Shepard, and Glantz British Medical
J  2004328977-980) 
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What are the cardiovascular risks of smoking?

• TF Pechacek, S Babb, Centers for Disease Control
  and Prevention, Atlanta, GA
• BMJ  2004328980-983 

There is a direct relationship between the risk
of ischaemic heart disease and number of
cigarettes smoked
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How acute are the cardiovascular risks of
secondhand smoke?

• TF Pechacek, S Babb, Centers for Disease Control
  and Prevention, Atlanta, GA
• BMJ  2004328980-983 

Exposure to second-hand smoke can pose acute
risks to those with pre-existing coronary disease
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The Fallacy of Ventilation





What can we do about second hand smoke?
  Home FAQs Site Policy Site Map Contact
Us Glossary of Terms Industry Associations
Secondhand Smoke Our programs are not
intended to address health affects of secondhand
smoke.
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The Fallacy of Ventilation

• Many of the components in smoke
• condense on surfaces and form a sticky film
  that then outgases toxic substances thus
  defeating ventilation systems
• At one air change per hour, it takes more than
  three hours for 95 of the smoke in a room to
  dissipate once smoking has ended
• To reduce risk from secondhand smoke,
  ventilation rates would have to be increased
• more than 1000 times, resulting in a hurricane

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Smokefree environments





What can we do about second-hand smoke?

• Quickly reduce the adverse health effects of
  exposure
• (Data from California shows that within
  months after prohibition of
• smoking in bars there was a significant
  reduction in respiratory disease
• among bartenders
• Reduce initiation and lower smoking rates
• (In 2000, California had a smoking prevalence
  of 17.2
• compared to 23.3 for Iowa)
• Reduce chronic disease
• (California has had a significantly greater
  decline in lung cancer
• than any other state)

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Questions?
College of Dentistry, University of Iowa, Iowa
City