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Clearing the air about secondhand smoke
Clearing the About Secondhand
Air Smoke
A Bigger Health Risk Than You May Think
When Kirk Day had a heart attack in April 2005, addressing the heart problems—in his case, blocked valves—was the easy part. His complications were respiratory. He remained in the intensive care unit, unconscious and unable to breathe without the aid of a ventilator. His health care team was baffled. “He’s a smoker, right?” the nurses asked repeatedly. No, he was not a smoker, his family insisted. Finally someone mentioned, “But our mother smoked for 49 years.” “I’d say that makes him a smoker,” said the nurse. She scrawled “Smoker’s Lungs” on his file.
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ASTHMA MAGAZINE
September/October 2005
by Gretchen W. Cook
“A burning cigarette is like a little toxic waste dump on fire,” says Karen Kacirk, assistant director of the University of California, San Francisco, Center for Tobacco Control Research and Education. “It puts more than 4,800 chemicals into the air, including at least 69 solvents and irritants. We now know that secondhand smoke causes the same diseases in non-smokers as smokers [are at risk for]: heart attacks, asthma attacks and other breathing problems (particularly in children), lung and other cancers.”
cancer, and lung disease caused by their exposure to secondhand smoke—more than die in auto accidents.”
How Dangerous Is Secondhand Smoke? Cardiovascular Effects
Secondhand smoke is dangerous for everyone who is exposed to it; however, it is children who are exposed to the smoke of parents and other adults in their lives who may be at the greatest risk. “[Children’s] bodies are still developing rapidly and, [given] their smaller size, they take more breaths than adults,” says Kacirk. “Probably because of these facts, the first evidence that secondhand smoke was dangerous for people appeared over 30 years ago when physicians and medical scientists found that children exposed to secondhand smoke were more likely to have asthma, respiratory problems, and ear infections.” It is not just children who are affected by secondhand smoke. Adults face it in homes, restaurants, bars and, for many decades (although less so now), the workplace. A “non-smoker” who is frequently exposed to cigarette smoke is basically a secondhand smoker. In fact, recent research indicates secondhand smoke, or passive smoke, is a far greater health risk than was previously understood. Routine exposure to someone else’s cigarette smoke, or “secondhand smoking,” can increase your risk of heart disease by 30%. It also elevates your risk of cancer and lung disease. According to Kacirk, “Each year at least 53,000 American non-smokers die from heart disease,
When a smoker inhales, the concentration of harmful chemicals found in the cigarette is very high. With secondhand or passive smoke, the chemicals are diluted— in some cases as much as 100 times less than their concentrations in the smoke inhaled directly from a cigarette. So that means the risk would be about 100 times less, right? The answer is absolutely not. In fact, colleagues Joaquin Barnoya, MD, MPH, and Stanton A. Glantz, PhD, of the Center for Tobacco Control Research and Education maintain that the cardiovascular effects of secondhand smoke are nearly equal to those faced by smoking itself (Circulation 2005;111:2684-98). Increasingly, we are learning that the cardiovascular system is extremely sensitive to the toxins in secondhand smoke. According to one study, in as little as 30 minutes of exposure to cigarette smoke—the level you might expect to find at a bar—measurable changes take place in your coronary arteries (JAMA 2001;286:436-41). Secondhand smoking also accelerates the development of atherosclerosis (stiffening of the aortic arteries). It also contributes to the accumulation of bad forms of cholesterol (LDL) in the body and reductions in the good forms of cholesterol (HDL). Overall, secondhand or passive smoking has a much greater effect on the cardiovascular system than is expected from a comparison of the doses of toxins delivered to active and passive smokers. Some may wonder, “It's just a few hours in a bar. What difference will it make?” Quite a bit. “For every five or six active smokers felled by heart disease, a nonsmoker exposed to their secondhand smoke also dies from the exposure,” says Kacirk. “That is something to think about along the bar rail.”
Respiratory Effects “There is no safe level of secondhand smoke,” says Kacirk. “The chemicals in secondhand smoke are responsible for wheezing and asthma attacks for many individuals.” For people with asthma, and those for whom cigarette smoke is a known trigger, even a visit to a local restaurant can put them in danger of having an asthma flare. A large number of studies done over the years have looked at the many ways secondhand smoke effects lung health. The evidence is particularly plentiful in looking at its effects on children. Children who are exposed to secondhand smoke, both directly and while in their
ASTHMA MAGAZINE
to subscribe call 1.800.654.2452
|
25
make even a non-smoking section of an indoor facility the “secondhand smoking” section. Many people hesitate when faced with unwanted secondhand smoke. They don’t want to make a scene or draw attention to themselves. Current information on the many health risks bolsters one’s stance when it comes to secondhand smoke. Ask to be removed from the situation, or leave. Until legislation passes to create more smoke-free public spaces and work places, it will be difficult to completely avoid secondhand smoke in group or public environments. However, it is possible to control the environment of your home. “It is important for children, grown-ups, and families to understand [the risks of secondhand smoke] and the importance of making homes and cars smoke-free,” says Kacirk. Secondhand smoking is not just a minor annoyance to be tolerated. Its effects are far greater than the lingering scent on clothes and in hair. Studies show that exposure to secondhand smoke is a health risk for everyone. For individuals with asthma, it is even more important to avoid what is not only a known asthma trigger, but a recognized toxic substance. Gretchen W. Cook is a freelance writer in Jackson, Mississippi, who specializes in family and health topics. She was diagnosed with asthma at age 6. mother’s womb, have a higher likelihood of developing asthma (Am J Respir Crit Care Med 2005;172:61-6). Children exposed to secondhand smoke in their homes in the first year of life may have higher rates of respiratory illness, which in itself can be a significant trigger of asthma (Pediatrics 1985;75:594-7). Children who have asthma and whose mothers smoke may have more frequent asthma episodes and more severe symptoms (J Allergy Clin Immunol 1986;77:575-81). The effects of secondhand smoke can be quite dangerous for adults as well. Adults whose partners smoke are nearly five times more likely to develop asthma in adulthood than those who are not exposed to passive smoke (findings presented by Maritta Jaakkola at the 11th European Congress on Lung Disease, Berlin, 2001). Adults who are regularly exposed to secondhand smoke in the workplace may experience more chest tightness, nighttime breathlessness, breathlessness after physical activity, and general bronchial responsiveness than people not exposed to secondhand smoke (Lancet 2001;358:2103-9). In addition, daily exposure to secondhand smoke at home or in the workplace may cause a significant increase in the risk of chronic bronchitis, asthma, and wheezing (Chest 2002;122:1086-90).
Going Smoke Free Exposure to secondhand smoke can be difficult to avoid. Because of its very nature, smoke drifts. It can
26
|
ASTHMA MAGAZINE
September/October 2005
Reprint requests: Elsevier Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318; phone 314-453-4350. doi:10.1016/j.asthmamag.2005.09.001
Air Smoke
A Bigger Health Risk Than You May Think
When Kirk Day had a heart attack in April 2005, addressing the heart problems—in his case, blocked valves—was the easy part. His complications were respiratory. He remained in the intensive care unit, unconscious and unable to breathe without the aid of a ventilator. His health care team was baffled. “He’s a smoker, right?” the nurses asked repeatedly. No, he was not a smoker, his family insisted. Finally someone mentioned, “But our mother smoked for 49 years.” “I’d say that makes him a smoker,” said the nurse. She scrawled “Smoker’s Lungs” on his file.
24
|
ASTHMA MAGAZINE
September/October 2005
by Gretchen W. Cook
“A burning cigarette is like a little toxic waste dump on fire,” says Karen Kacirk, assistant director of the University of California, San Francisco, Center for Tobacco Control Research and Education. “It puts more than 4,800 chemicals into the air, including at least 69 solvents and irritants. We now know that secondhand smoke causes the same diseases in non-smokers as smokers [are at risk for]: heart attacks, asthma attacks and other breathing problems (particularly in children), lung and other cancers.”
cancer, and lung disease caused by their exposure to secondhand smoke—more than die in auto accidents.”
How Dangerous Is Secondhand Smoke? Cardiovascular Effects
Secondhand smoke is dangerous for everyone who is exposed to it; however, it is children who are exposed to the smoke of parents and other adults in their lives who may be at the greatest risk. “[Children’s] bodies are still developing rapidly and, [given] their smaller size, they take more breaths than adults,” says Kacirk. “Probably because of these facts, the first evidence that secondhand smoke was dangerous for people appeared over 30 years ago when physicians and medical scientists found that children exposed to secondhand smoke were more likely to have asthma, respiratory problems, and ear infections.” It is not just children who are affected by secondhand smoke. Adults face it in homes, restaurants, bars and, for many decades (although less so now), the workplace. A “non-smoker” who is frequently exposed to cigarette smoke is basically a secondhand smoker. In fact, recent research indicates secondhand smoke, or passive smoke, is a far greater health risk than was previously understood. Routine exposure to someone else’s cigarette smoke, or “secondhand smoking,” can increase your risk of heart disease by 30%. It also elevates your risk of cancer and lung disease. According to Kacirk, “Each year at least 53,000 American non-smokers die from heart disease,
When a smoker inhales, the concentration of harmful chemicals found in the cigarette is very high. With secondhand or passive smoke, the chemicals are diluted— in some cases as much as 100 times less than their concentrations in the smoke inhaled directly from a cigarette. So that means the risk would be about 100 times less, right? The answer is absolutely not. In fact, colleagues Joaquin Barnoya, MD, MPH, and Stanton A. Glantz, PhD, of the Center for Tobacco Control Research and Education maintain that the cardiovascular effects of secondhand smoke are nearly equal to those faced by smoking itself (Circulation 2005;111:2684-98). Increasingly, we are learning that the cardiovascular system is extremely sensitive to the toxins in secondhand smoke. According to one study, in as little as 30 minutes of exposure to cigarette smoke—the level you might expect to find at a bar—measurable changes take place in your coronary arteries (JAMA 2001;286:436-41). Secondhand smoking also accelerates the development of atherosclerosis (stiffening of the aortic arteries). It also contributes to the accumulation of bad forms of cholesterol (LDL) in the body and reductions in the good forms of cholesterol (HDL). Overall, secondhand or passive smoking has a much greater effect on the cardiovascular system than is expected from a comparison of the doses of toxins delivered to active and passive smokers. Some may wonder, “It's just a few hours in a bar. What difference will it make?” Quite a bit. “For every five or six active smokers felled by heart disease, a nonsmoker exposed to their secondhand smoke also dies from the exposure,” says Kacirk. “That is something to think about along the bar rail.”
Respiratory Effects “There is no safe level of secondhand smoke,” says Kacirk. “The chemicals in secondhand smoke are responsible for wheezing and asthma attacks for many individuals.” For people with asthma, and those for whom cigarette smoke is a known trigger, even a visit to a local restaurant can put them in danger of having an asthma flare. A large number of studies done over the years have looked at the many ways secondhand smoke effects lung health. The evidence is particularly plentiful in looking at its effects on children. Children who are exposed to secondhand smoke, both directly and while in their
ASTHMA MAGAZINE
to subscribe call 1.800.654.2452
|
25
make even a non-smoking section of an indoor facility the “secondhand smoking” section. Many people hesitate when faced with unwanted secondhand smoke. They don’t want to make a scene or draw attention to themselves. Current information on the many health risks bolsters one’s stance when it comes to secondhand smoke. Ask to be removed from the situation, or leave. Until legislation passes to create more smoke-free public spaces and work places, it will be difficult to completely avoid secondhand smoke in group or public environments. However, it is possible to control the environment of your home. “It is important for children, grown-ups, and families to understand [the risks of secondhand smoke] and the importance of making homes and cars smoke-free,” says Kacirk. Secondhand smoking is not just a minor annoyance to be tolerated. Its effects are far greater than the lingering scent on clothes and in hair. Studies show that exposure to secondhand smoke is a health risk for everyone. For individuals with asthma, it is even more important to avoid what is not only a known asthma trigger, but a recognized toxic substance. Gretchen W. Cook is a freelance writer in Jackson, Mississippi, who specializes in family and health topics. She was diagnosed with asthma at age 6. mother’s womb, have a higher likelihood of developing asthma (Am J Respir Crit Care Med 2005;172:61-6). Children exposed to secondhand smoke in their homes in the first year of life may have higher rates of respiratory illness, which in itself can be a significant trigger of asthma (Pediatrics 1985;75:594-7). Children who have asthma and whose mothers smoke may have more frequent asthma episodes and more severe symptoms (J Allergy Clin Immunol 1986;77:575-81). The effects of secondhand smoke can be quite dangerous for adults as well. Adults whose partners smoke are nearly five times more likely to develop asthma in adulthood than those who are not exposed to passive smoke (findings presented by Maritta Jaakkola at the 11th European Congress on Lung Disease, Berlin, 2001). Adults who are regularly exposed to secondhand smoke in the workplace may experience more chest tightness, nighttime breathlessness, breathlessness after physical activity, and general bronchial responsiveness than people not exposed to secondhand smoke (Lancet 2001;358:2103-9). In addition, daily exposure to secondhand smoke at home or in the workplace may cause a significant increase in the risk of chronic bronchitis, asthma, and wheezing (Chest 2002;122:1086-90).
Going Smoke Free Exposure to secondhand smoke can be difficult to avoid. Because of its very nature, smoke drifts. It can
26
|
ASTHMA MAGAZINE
September/October 2005
Reprint requests: Elsevier Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318; phone 314-453-4350. doi:10.1016/j.asthmamag.2005.09.001