Passive Smoker Speech

8/13/2019 Passive Smoker Speech

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s passive smoking harmful?

Yes. Breathing in someone elses cigarette smoke (passive smoking or secondhand smoking) can

increase your risk of cancer and other health problems. It is also particularly harmful for

children.

Smoke stays in the air

When someone smokes a cigarette, the smoke from the burning tip is released into the air. So isthe smoke they breathe out. Smoke can stay in the air for up to two and a half hours even with awindow open. It may still be there even if you cant see it or smell it.

This also applies in small enclosed places, such as cars. Smoke may still be present in largeamounts even after the person has stopped smoking.

Risks of passive smoking

Passive smoking can damage your body because secondhand smoke contains more than 4,000chemicals, many of which are irritants and toxins, and some of which are known to cause cancer.Passive smoking from all forms of tobacco is harmful, including:

cigarettes cigars pipe tobacco hand-rolling tobacco

Frequent exposure to otherpeoples smoke can increase your risk oflung cancer,even if yourea non-smoker. Passive smoking also increases your risk ofcoronary heart disease.Coronaryheart disease can cause aheart attack,angina(chest pain) andheart failure.It aslo increases yourrisk ofstroke.

Children and passive smoking

Breathing in secondhand smoke is particularly harmful for children. Children who breathe insecondhand smoke have an increased risk of:

cot death (sudden infant death syndromeor SIDS)this is twice as likely in babieswhose mothers smoke

developingasthmasmoking can also trigger asthma attacks in children who alreadyhave the condition

serious respiratory (breathing) conditions such asbronchitisandpneumoniayoungerchildren are also much more likely to be admitted to hospital for a serious respiratoryinfection

meningitis
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coughsandcolds middle ear disease, such asotitis media(a middle ear infection), which can causehearing

loss

Children who grow up with a parent or family member who smokes are three times as likely to

start smoking themselves.

If youre a parent who smokes, it will be hard to explain to your children why they shouldnt

start smoking. Try to lead by example and quit. As well as improving your health and theirs,your children may be less likely to start smoking later in life. See below for where to get support.

Smoking and the law

In July 2007, smoking in public places, such as bars, restaurants and workplaces, was madeillegal to protect non-smokers from the health risks associated with passive smoking.

Stopping smoking

Read more abouttreatment and support to quit smoking,as well as advice aboutself-helpwhenyoure preparing to stop.

Your GP can also give you advice about quitting smoking and NHS stop smoking supportservices throughGo Smokefree.

Read the answers to more questions aboutstopping smoking.

Further information:

What are the health risks of smoking? Where can I get help with quitting smoking? Stop smoking help Download our quit smoking widget Go Smokefree QUIT: I want to quit

Passive smoking means breathing in other peoples tobacco smoke. Exhaled smoke is calledexhaled mainstream smoke. The smoke drifting from a lit cigarette is called sidestream smoke.The combination of mainstream and sidestream smoke is called second-hand smoke (SHS) orenvironmental tobacco smoke (ETS).

Second-hand smoke is a common indoor pollutant in the home, making passive smoking a
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serious health risk for both those who smoke and those who do not. Children are particularly atrisk of serious health effects from second-hand smoke.

In Victoria, it is illegal to smoke in cars carrying children who are under 18 years of age.

Irritant effects of passive smoking

Tobacco smoke inside a room tends to hang in mid-air rather than disperse. Hot smoke rises, buttobacco smoke cools rapidly, which stops its upward climb. Since the smoke is heavier than theair, the smoke starts to descend.

A person who smokes heavily indoors causes a permanent low-lying smoke cloud that otherhouseholders have no choice but to breathe.

Tobacco smoke contains around 7,000 chemicals, made up of particles and gases, over 50 of

which are known to cause cancer. Second-hand smoke has been confirmed as a cause of lungcancer in humans by several leading health authorities.

Compounds such as ammonia, sulphur and formaldehyde irritate the eyes, nose, throat and lungs.These compounds are especially harmful to people with respiratory conditions such as bronchitisor asthma. Exposure to second-hand smoke can either trigger or worsen symptoms.

Health risks of passive smokingpregnant women and

unborn babies

Australian data indicates that about 12 per cent of women smoke during pregnancy. Bothsmoking and passive smoking can seriously affect the developing fetus.

Health risks for mothers who smoke during pregnancy include:

Increased risk of miscarriage and stillbirth Increased risk of premature birth and low birth weight Increased risk of sudden unexpected death in infants (SUDI), which includes sudden

infant death syndrome (SIDS) and fatal sleep accidents Increased risk of complications during birth.

A non-smoking pregnant woman is more likely to give birth to a baby with a slightly lower birthweight if she is exposed to second-hand smoke in the homefor example, if her partner smokes.

Health risks of passive smokingchildren


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Children are especially vulnerable to the damaging effects of second-hand smoke. Some of themany health risks include:

Passive smoking is a cause of sudden unexpected death in infants (SUDI), which includes

sudden infant death syndrome (SIDS) and fatal sleep accidents. A child who lives in a smoking household for the first 18 months of their life has an

increased risk of developing a range of respiratory illnesses including bronchitis,bronchiolitis and pneumonia. They are also more prone to getting colds, coughs and glueear (middle ear infections). Their lungs show a reduced ability to function and slowergrowth.

A child exposed to second-hand smoke in the home is more likely to develop asthmasymptoms, have more asthma attacks and use asthma medications more often and for alonger period.

School-aged children of people who smoke are more likely to have symptoms such ascough, phlegm, wheeze and breathlessness.

Children of people who smoke have an increased risk of meningococcal disease, whichcan sometimes cause death or disability.

Health risks of passive smokingpartners who have never

smoked

People who have never smoked who live with people who do smoke are at increased risk of arange of tobacco-related diseases and other health risks, including:

Passive smoking increases the risk of heart disease. There is consistent evidence thatpeople who do not smoke, who live in a smoky household, have higher risks of coronaryheart disease than those who do not.

Passive smoking makes the blood more sticky and likely to clot, thereby leading to

increased risk of various health conditions, including heart attack and stroke. There is evidence that passive smoking can cause levels of antioxidant vitamins in the

blood to reduce. Just 30 minutes of exposure to second-hand smoke can affect how your blood vessels

regulate blood flow, to a similar degree to that seen in people who smoke. Long-term exposure to passive smoking may lead to the development of atherosclerosis

(narrowing of the arteries). People who do not smoke who suffer long-term exposure to second-hand smoke have a

20 to 30 per cent higher risk of developing lung cancer. There is increasing evidence that passive smoking can increase the risk of stroke, nasal

sinus cancer, throat cancer, breast cancer, long- and short-term respiratory symptoms,loss of lung function, and chronic obstructive pulmonary disease among people who donot smoke.

It is estimated that in Australia, in the financial year 200405, 113 adults and 28 infantsdied from diseases caused by second-hand smoke in the home.


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Passive smokinga good reason to quit

The risks of active smoking are well known. If a person who smokes cant give up for their ownhealth, then the health of their family or other members of their household could be a stronger

motivation. There is a wealth of assistance for people who wish to stop smoking. See your doctorfor further information and advice, or ring the Quitline on 13 7848.

Reducing the risk of passive smoking

If a person who smokes is unwilling or unable to stop immediately, there are various ways tohelp protect the health of the people with whom they live. Suggestions include:

Make your home smoke-free. Limiting your smoking to one or two rooms is not an

effective measuretobacco smoke can easily drift through the rest of the house. Make sure that visitors to your house smoke their cigarettes outdoors. Make your car smoke-free. The other occupants will still be exposed to tobacco smoke

even if the windows are open. In Victoria, it is illegal to smoke in cars carrying childrenwho are under 18 years of age.

Dont allow smoking in any enclosed space where people who do not smoke spend timefor example, in the garage, shed, cubby house, boat or caravan.

Try to avoid taking children to outdoor areas where people are smoking and you canteasily move away, such as a caf courtyard.

Make sure that all people who look after your children provide a smoke-freeenvironment.

Where to get help

Your doctor Your pharmacist Quitline Tel. 13 7848

Things to remember

In Victoria, it is illegal to smoke in cars carrying children who are under 18 years of age,

and in enclosed workplaces. If a person who smokes cant give up for their own health, perhaps the health of their

partner or children, or other members of their household, will be a stronger motivation. Passive smoking increases the risk of respiratory illnesses in children, including asthma,

bronchitis and pneumonia. People who have never smoked who live with people who do smoke are at increased risk

of a range of tobacco-related diseases including lung cancer, heart disease and stroke.


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Effects

Second-hand smoke causes many of the same diseases as direct smoking, includingcardiovascular diseases,lung cancer,andrespiratory diseases.[2][3][8]These diseases include:

Cancer:o General: overall increased risk;

[9]reviewing the evidence accumulated on a worldwide

basis, theInternational Agency for Research on Cancerconcluded in 2004 that

"Involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) is

carcinogenic to humans."[3]

o Lung cancer:the effect of passive smoking on lung cancer has been extensively studied.

A series of studies from the USA from 19862003,[10][11][12][13]

the UK in 1998,[14][15]

Australia in 1997[16]

and internationally in 2004[17]

have consistently shown a significant

increase inrelative riskamong those exposed to passive smoke.[18]

o Breast cancer:TheCalifornia Environmental Protection Agencyconcluded in 2005 that

passive smoking increases the risk of breast cancer in younger, primarily premenopausal

women by 70%[8]

and the USSurgeon Generalhas concluded that the evidence is"suggestive," but still insufficient to assert such a causal relationship.[2]In contrast, the

International Agency for Research on Cancerconcluded in 2004 that there was "no

support for a causal relation between involuntary exposure to tobacco smoke and

breast cancer in never-smokers."[3]

o Renal cell carcinoma(RCC): A recent study shows an increased RCC risk among never

smokers with combined home/work exposure to passive smoking.[19]

o Passive smoking does not appear to be associated withpancreatic cancer.[20]

o Brain tumor:The risk in children increases significantly with higher amount of passive

smoking, even if the mother doesn't smoke,[21]

thus not restricting risk toprenatal

exposureduring pregnancy.

Ear, nose, and throat:risk of ear infections.[22]

o Second-hand smoke exposure is associated with hearing loss in non-smoking adults.[23]

Circulatory system:risk ofheart disease,[24]reduced heart rate variability, higher heart rate.[25]

o Epidemiological studies have shown that both active and passive cigarette smoking

increase the risk of atherosclerosis.[26]

Lung problems:

o Risk ofasthma.[27]

Cognitive impairmentanddementia:Exposure to secondhand smoke may increase the risk of

cognitive impairment and dementia in adults 50 and over.[28]

Duringpregnancy:

o Low birth weight[8], part B, ch. 3

.[29]

o Premature birth[8], part B, ch. 3

(Note that evidence of the causal link is only described as

"suggestive" by the US Surgeon General in his 2006 report.[30])o Damage to children'scarotid arteriesat birth and at age 5

[31]

o Recent studies comparing women exposed to Environmental Tobacco Smoke and non-

exposed women, demonstrate that women exposed while pregnant have higher risks of

delivering a child with congenital abnormalities, longer lengths, smaller head

circumferences, and low birth weight.[32]

General:

o Worsening of asthma, allergies, and other conditions.[33]
http://en.wikipedia.org/wiki/Cardiovascular_diseasehttp://en.wikipedia.org/wiki/Cardiovascular_diseasehttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Respiratory_diseasehttp://en.wikipedia.org/wiki/Respiratory_diseasehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/Passive_smoking#cite_note-calepa2005-8http://en.wikipedia.org/wiki/Passive_smoking#cite_note-calepa2005-8http://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-9http://en.wikipedia.org/wiki/Passive_smoking#cite_note-9http://en.wikipedia.org/wiki/Passive_smoking#cite_note-9http://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-10http://en.wikipedia.org/wiki/Passive_smoking#cite_note-10http://en.wikipedia.org/wiki/Passive_smoking#cite_note-EPA_report-12http://en.wikipedia.org/wiki/Passive_smoking#cite_note-EPA_report-12http://en.wikipedia.org/wiki/Passive_smoking#cite_note-14http://en.wikipedia.org/wiki/Passive_smoking#cite_note-14http://en.wikipedia.org/wiki/Passive_smoking#cite_note-14http://en.wikipedia.org/wiki/Passive_smoking#cite_note-16http://en.wikipedia.org/wiki/Passive_smoking#cite_note-16http://en.wikipedia.org/wiki/Passive_smoking#cite_note-16http://en.wikipedia.org/wiki/Passive_smoking#cite_note-17http://en.wikipedia.org/wiki/Passive_smoking#cite_note-17http://en.wikipedia.org/wiki/Relative_riskhttp://en.wikipedia.org/wiki/Relative_riskhttp://en.wikipedia.org/wiki/Relative_riskhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-18http://en.wikipedia.org/wiki/Passive_smoking#cite_note-18http://en.wikipedia.org/wiki/Passive_smoking#cite_note-18http://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/California_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/California_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/California_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-calepa2005-8http://en.wikipedia.org/wiki/Passive_smoking#cite_note-calepa2005-8http://en.wikipedia.org/wiki/Surgeon_General_of_the_United_Stateshttp://en.wikipedia.org/wiki/Surgeon_General_of_the_United_Stateshttp://en.wikipedia.org/wiki/Surgeon_General_of_the_United_Stateshttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/Renal_cell_carcinomahttp://en.wikipedia.org/wiki/Renal_cell_carcinomahttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-19http://en.wikipedia.org/wiki/Passive_smoking#cite_note-19http://en.wikipedia.org/wiki/Passive_smoking#cite_note-19http://en.wikipedia.org/wiki/Pancreatic_cancerhttp://en.wikipedia.org/wiki/Pancreatic_cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-20http://en.wikipedia.org/wiki/Passive_smoking#cite_note-20http://en.wikipedia.org/wiki/Passive_smoking#cite_note-20http://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-21http://en.wikipedia.org/wiki/Passive_smoking#cite_note-21http://en.wikipedia.org/wiki/Passive_smoking#cite_note-21http://en.wikipedia.org/wiki/Smoking_and_pregnancyhttp://en.wikipedia.org/wiki/Smoking_and_pregnancyhttp://en.wikipedia.org/wiki/Smoking_and_pregnancyhttp://en.wikipedia.org/wiki/Smoking_and_pregnancyhttp://en.wikipedia.org/wiki/Otolaryngologyhttp://en.wikipedia.org/wiki/Otolaryngologyhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-22http://en.wikipedia.org/wiki/Passive_smoking#cite_note-22http://en.wikipedia.org/wiki/Passive_smoking#cite_note-22http://en.wikipedia.org/wiki/Passive_smoking#cite_note-23http://en.wikipedia.org/wiki/Passive_smoking#cite_note-23http://en.wikipedia.org/wiki/Passive_smoking#cite_note-23http://en.wikipedia.org/wiki/Circulatory_systemhttp://en.wikipedia.org/wiki/Circulatory_systemhttp://en.wikipedia.org/wiki/Heart_diseasehttp://en.wikipedia.org/wiki/Heart_diseasehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-24http://en.wikipedia.org/wiki/Passive_smoking#cite_note-24http://en.wikipedia.org/wiki/Passive_smoking#cite_note-24http://en.wikipedia.org/wiki/Passive_smoking#cite_note-25http://en.wikipedia.org/wiki/Passive_smoking#cite_note-25http://en.wikipedia.org/wiki/Passive_smoking#cite_note-25http://en.wikipedia.org/wiki/Passive_smoking#cite_note-26http://en.wikipedia.org/wiki/Passive_smoking#cite_note-26http://en.wikipedia.org/wiki/Passive_smoking#cite_note-26http://en.wikipedia.org/wiki/Respiratory_systemhttp://en.wikipedia.org/wiki/Respiratory_systemhttp://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-27http://en.wikipedia.org/wiki/Passive_smoking#cite_note-27http://en.wikipedia.org/wiki/Passive_smoking#cite_note-27http://en.wikipedia.org/wiki/Cognitive_impairmenthttp://en.wikipedia.org/wiki/Cognitive_impairmenthttp://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-28http://en.wikipedia.org/wiki/Passive_smoking#cite_note-28http://en.wikipedia.org/wiki/Passive_smoking#cite_note-28http://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Birth_masshttp://en.wikipedia.org/wiki/Birth_masshttp://en.wikipedia.org/wiki/Birth_masshttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-29http://en.wikipedia.org/wiki/Passive_smoking#cite_note-29http://en.wikipedia.org/wiki/Passive_smoking#cite_note-29http://en.wikipedia.org/wiki/Premature_birthhttp://en.wikipedia.org/wiki/Premature_birthhttp://en.wikipedia.org/wiki/Premature_birthhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-30http://en.wikipedia.org/wiki/Passive_smoking#cite_note-30http://en.wikipedia.org/wiki/Passive_smoking#cite_note-30http://en.wikipedia.org/wiki/Carotid_arterieshttp://en.wikipedia.org/wiki/Carotid_arterieshttp://en.wikipedia.org/wiki/Carotid_arterieshttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-31http://en.wikipedia.org/wiki/Passive_smoking#cite_note-31http://en.wikipedia.org/wiki/Passive_smoking#cite_note-31http://en.wikipedia.org/wiki/Passive_smoking#cite_note-32http://en.wikipedia.org/wiki/Passive_smoking#cite_note-32http://en.wikipedia.org/wiki/Passive_smoking#cite_note-32http://en.wikipedia.org/wiki/Passive_smoking#cite_note-33http://en.wikipedia.org/wiki/Passive_smoking#cite_note-33http://en.wikipedia.org/wiki/Passive_smoking#cite_note-33http://en.wikipedia.org/wiki/Passive_smoking#cite_note-33http://en.wikipedia.org/wiki/Passive_smoking#cite_note-32http://en.wikipedia.org/wiki/Passive_smoking#cite_note-31http://en.wikipedia.org/wiki/Carotid_arterieshttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-30http://en.wikipedia.org/wiki/Premature_birthhttp://en.wikipedia.org/wiki/Premature_birthhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-29http://en.wikipedia.org/wiki/Birth_masshttp://en.wikipedia.org/wiki/Birth_masshttp://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-28http://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Cognitive_impairmenthttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-27http://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Respiratory_systemhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-26http://en.wikipedia.org/wiki/Passive_smoking#cite_note-25http://en.wikipedia.org/wiki/Passive_smoking#cite_note-24http://en.wikipedia.org/wiki/Heart_diseasehttp://en.wikipedia.org/wiki/Circulatory_systemhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-23http://en.wikipedia.org/wiki/Passive_smoking#cite_note-22http://en.wikipedia.org/wiki/Otolaryngologyhttp://en.wikipedia.org/wiki/Smoking_and_pregnancyhttp://en.wikipedia.org/wiki/Smoking_and_pregnancyhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-21http://en.wikipedia.org/wiki/Brain_tumorhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-20http://en.wikipedia.org/wiki/Pancreatic_cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-19http://en.wikipedia.org/wiki/Renal_cell_carcinomahttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/Surgeon_General_of_the_United_Stateshttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-calepa2005-8http://en.wikipedia.org/wiki/California_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/Breast_cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-18http://en.wikipedia.org/wiki/Relative_riskhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-17http://en.wikipedia.org/wiki/Passive_smoking#cite_note-16http://en.wikipedia.org/wiki/Passive_smoking#cite_note-14http://en.wikipedia.org/wiki/Passive_smoking#cite_note-14http://en.wikipedia.org/wiki/Passive_smoking#cite_note-EPA_report-12http://en.wikipedia.org/wiki/Passive_smoking#cite_note-EPA_report-12http://en.wikipedia.org/wiki/Passive_smoking#cite_note-10http://en.wikipedia.org/wiki/Passive_smoking#cite_note-10http://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-9http://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-calepa2005-8http://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/Passive_smoking#cite_note-sg-report-2http://en.wikipedia.org/wiki/Respiratory_diseasehttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Cardiovascular_disease


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Skin Disorder

o Childhood exposure to Environmental Tobacco Smoke is associated with an increased

risk of the development of adult-onset Atopic dermatitis.[34]

Overall increased risk of death in both adults, where it is estimated to kill 53,000 nonsmokers

per year, making it the 3rd leading cause ofpreventable deathin the U.S.[35][36]and in

children.[37]Another research financed by the Swedish National Board of Health and Welfare and

Bloomberg Philanthropies found that passive smoking causes about 603,000 death a year, which

represents 1% of the world's death.[38]

Risk to children

Sudden infant death syndrome(SIDS).[39][40]In his 2006 report, the US Surgeon General

concludes: "The evidence is sufficient to infer a causal relationship between exposure to

secondhand smoke and sudden infant death syndrome."[41]

Secondhand smoking has been

estimated to be associated with 430 SIDS deaths in the United States annually.[42]

Asthma[43][44]

Lung infections,[45][46][47][48]

also including more severe illness withbronchiolitis[49]

and

bronchitis,[50]and worse outcome,[49]as well as increased risk of developingtuberculosisif

exposed to a carrier[51]

In the United States, it is estimated that second hand smoke has been

associated with between 150,000 and 300,000 lower respiratory tract infections in infants and

children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each

year.[42]

Impaired respiratory function and slowed lung growth[50]

Allergies

Crohn's disease.[52]

Learning difficulties, developmental delays, and neurobehavioral effects.[53][54]

Animal models

suggest a role for nicotine andcarbon monoxidein neurocognitive problems.[48]

An increase intooth decay(as well as related salivarybiomarkers)has been associated with

passive smoking in children.[55]

Increased risk of middle ear infections.

[56][57]

Evidence
http://en.wikipedia.org/wiki/Passive_smoking#cite_note-34http://en.wikipedia.org/wiki/Passive_smoking#cite_note-34http://en.wikipedia.org/wiki/Passive_smoking#cite_note-34http://en.wikipedia.org/wiki/Preventable_deathhttp://en.wikipedia.org/wiki/Preventable_deathhttp://en.wikipedia.org/wiki/Preventable_deathhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-35http://en.wikipedia.org/wiki/Passive_smoking#cite_note-35http://en.wikipedia.org/wiki/Passive_smoking#cite_note-35http://en.wikipedia.org/wiki/Passive_smoking#cite_note-37http://en.wikipedia.org/wiki/Passive_smoking#cite_note-37http://en.wikipedia.org/wiki/Passive_smoking#cite_note-37http://en.wikipedia.org/wiki/Passive_smoking#cite_note-38http://en.wikipedia.org/wiki/Passive_smoking#cite_note-38http://en.wikipedia.org/wiki/Passive_smoking#cite_note-38http://en.wikipedia.org/wiki/Sudden_infant_death_syndromehttp://en.wikipedia.org/wiki/Sudden_infant_death_syndromehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-39http://en.wikipedia.org/wiki/Passive_smoking#cite_note-39http://en.wikipedia.org/wiki/Passive_smoking#cite_note-39http://en.wikipedia.org/wiki/Passive_smoking#cite_note-41http://en.wikipedia.org/wiki/Passive_smoking#cite_note-41http://en.wikipedia.org/wiki/Passive_smoking#cite_note-41http://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-44http://en.wikipedia.org/wiki/Passive_smoking#cite_note-44http://en.wikipedia.org/wiki/Passive_smoking#cite_note-45http://en.wikipedia.org/wiki/Passive_smoking#cite_note-45http://en.wikipedia.org/wiki/Passive_smoking#cite_note-47http://en.wikipedia.org/wiki/Passive_smoking#cite_note-47http://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Bronchitishttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-CDC2007-50http://en.wikipedia.org/wiki/Passive_smoking#cite_note-CDC2007-50http://en.wikipedia.org/wiki/Passive_smoking#cite_note-CDC2007-50http://en.wikipedia.org/wiki/Passive_smoking#cite_note-Chatzimichael-49http://en.wikipedia.org/wiki/Passive_smoking#cite_note-Chatzimichael-49http://en.wikipedia.org/wiki/Passive_smoking#cite_note-Chatzimichael-49http://en.wikipedia.org/wiki/Tuberculosishttp://en.wikipedia.org/wiki/Tuberculosishttp://en.wikipedia.org/wiki/Tuberculosishttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-51http://en.wikipedia.org/wiki/Passive_smoking#cite_note-51http://en.wikipedia.org/wiki/Passive_smoking#cite_note-51http://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Passive_smoking#cite_note-CDC2007-50http://en.wikipedia.org/wiki/Passive_smoking#cite_note-CDC2007-50http://en.wikipedia.org/wiki/Crohn%27s_diseasehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-52http://en.wikipedia.org/wiki/Passive_smoking#cite_note-52http://en.wikipedia.org/wiki/Passive_smoking#cite_note-52http://en.wikipedia.org/wiki/Passive_smoking#cite_note-53http://en.wikipedia.org/wiki/Passive_smoking#cite_note-53http://en.wikipedia.org/wiki/Passive_smoking#cite_note-53http://en.wikipedia.org/wiki/Carbon_monoxidehttp://en.wikipedia.org/wiki/Carbon_monoxidehttp://en.wikipedia.org/wiki/Carbon_monoxidehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-Difranza_2004-48http://en.wikipedia.org/wiki/Passive_smoking#cite_note-Difranza_2004-48http://en.wikipedia.org/wiki/Passive_smoking#cite_note-Difranza_2004-48http://en.wikipedia.org/wiki/Dental_carieshttp://en.wikipedia.org/wiki/Dental_carieshttp://en.wikipedia.org/wiki/Dental_carieshttp://en.wikipedia.org/wiki/Biomarkershttp://en.wikipedia.org/wiki/Biomarkershttp://en.wikipedia.org/wiki/Biomarkershttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-pmid18672230-55http://en.wikipedia.org/wiki/Passive_smoking#cite_note-pmid18672230-55http://en.wikipedia.org/wiki/Passive_smoking#cite_note-pmid18672230-55http://en.wikipedia.org/wiki/Passive_smoking#cite_note-56http://en.wikipedia.org/wiki/Passive_smoking#cite_note-56http://en.wikipedia.org/wiki/Passive_smoking#cite_note-56http://en.wikipedia.org/wiki/File:Exposure_to_secondhand_smoke_by_age,_race,_and_poverty_level_US.pnghttp://en.wikipedia.org/wiki/File:Exposure_to_secondhand_smoke_by_age,_race,_and_poverty_level_US.pnghttp://en.wikipedia.org/wiki/File:Exposure_to_secondhand_smoke_by_age,_race,_and_poverty_level_US.pnghttp://en.wikipedia.org/wiki/File:Exposure_to_secondhand_smoke_by_age,_race,_and_poverty_level_US.pnghttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-56http://en.wikipedia.org/wiki/Passive_smoking#cite_note-56http://en.wikipedia.org/wiki/Passive_smoking#cite_note-pmid18672230-55http://en.wikipedia.org/wiki/Biomarkershttp://en.wikipedia.org/wiki/Dental_carieshttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-Difranza_2004-48http://en.wikipedia.org/wiki/Carbon_monoxidehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-53http://en.wikipedia.org/wiki/Passive_smoking#cite_note-53http://en.wikipedia.org/wiki/Passive_smoking#cite_note-52http://en.wikipedia.org/wiki/Crohn%27s_diseasehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-CDC2007-50http://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Passive_smoking#cite_note-51http://en.wikipedia.org/wiki/Tuberculosishttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-Chatzimichael-49http://en.wikipedia.org/wiki/Passive_smoking#cite_note-CDC2007-50http://en.wikipedia.org/wiki/Bronchitishttp://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-47http://en.wikipedia.org/wiki/Passive_smoking#cite_note-47http://en.wikipedia.org/wiki/Passive_smoking#cite_note-45http://en.wikipedia.org/wiki/Passive_smoking#cite_note-45http://en.wikipedia.org/wiki/Passive_smoking#cite_note-44http://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-ala-42http://en.wikipedia.org/wiki/Passive_smoking#cite_note-41http://en.wikipedia.org/wiki/Passive_smoking#cite_note-39http://en.wikipedia.org/wiki/Passive_smoking#cite_note-39http://en.wikipedia.org/wiki/Sudden_infant_death_syndromehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-38http://en.wikipedia.org/wiki/Passive_smoking#cite_note-37http://en.wikipedia.org/wiki/Passive_smoking#cite_note-35http://en.wikipedia.org/wiki/Passive_smoking#cite_note-35http://en.wikipedia.org/wiki/Preventable_deathhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-34


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Exposure to secondhand smoke by age, race, and poverty level in the US.

Epidemiologicalstudies show that non-smokers exposed to second-hand smoke are at risk formany of the health problems associated with direct smoking. Most of the research has come fromstudies of nonsmokers who are married to a smoker. Those conclusions are also backed up by

further studies of workplace exposure to smoke.[58]

In 1992, theJournal of the American Medical Associationpublished a review of availableevidence on the relationship between second-hand smoke and heart disease, and estimated thatsecond-hand smoke exposure was responsible for 35,000 to 40,000 deaths per year in theUnitedStatesin the early 1980s.[59]Theabsolute risk increaseof heart disease due to ETS was 2.2%,while theattributable risk percentwas 23%.

Research using more exact measures of second-hand smoke exposure suggests that risks to non-smokers may be even greater than this estimate. A British study reported that exposure tosecond-hand smoke increases the risk of heart disease among non-smokers by as much as 60%,

similar to light smoking.[60]

Evidence also shows that inhaled sidestream smoke, the maincomponent of second-hand smoke, is about four times more toxic than mainstream smoke. Thisfact has been known to the tobacco industry since the 1980s, though it kept its findingssecret.[61][62][63][64]Some scientists believe that the risk of passive smoking, in particular the riskof developing coronary heart diseases, may have been substantially underestimated.[65]

A minority of epidemiologists have found it hard to understand how second-hand smoke, whichis more diluted than actively inhaled smoke, could have an effect that is such a large fraction ofthe added risk of coronary heart disease among active smokers.[66][67]One proposed explanationis that second-hand smoke is not simply a diluted version of "mainstream" smoke, but has adifferent composition with more toxic substances per gram of total particulate matter.[66]Passive

smoking appears to be capable of precipitating the acute manifestations of cardio-vasculardiseases (atherothrombosis) and may also have a negative impact on the outcome of patients whosuffer acute coronary syndromes.[68]

In 2004, theInternational Agency for Research on Cancer(IARC) of theWorld HealthOrganization(WHO) reviewed all significant published evidence related to tobacco smoking andcancer. It concluded:

These meta-analyses show that there is a statistically significant and consistent associationbetween lung cancer risk in spouses of smokers and exposure to second-hand tobacco smokefrom the spouse who smokes. The excess risk is of the order of 20% for women and 30% for

men and remains after controlling for some potential sources of bias and confounding.

[3]

Subsequent meta-analyses have confirmed these findings,[69][70]and additional studies havefound that high overall exposure to passive smoke even among people with non-smokingpartners is associated with greater risks than partner smoking and is widespread in non-smokers.[60]
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The National Asthma Council of Australia cites studies showing that second-hand smoke isprobably the most important indoor pollutant, especially around young children:[71]

Smoking by either parent, particularly by the mother, increases the risk of asthma in children.

The outlook for early childhood asthma is less favourable in smoking households.

Children with asthma who are exposed to smoking in the home generally have more severe

disease.

Many adults with asthma identify ETS as a trigger for their symptoms.

Doctor-diagnosed asthma is more common among non-smoking adults exposed to ETS than

those not exposed. Among people with asthma, higher ETS exposure is associated with a greater

risk of severe attacks.

InFrance,exposure to second-hand smoke has been estimated to cause between 3,000[72]and5,000 premature deaths per year, with the larger figure cited by Prime ministerDominique deVillepinduring his announcement of a nationwide smoke-free law: "That makes more than 13deaths a day. It is an unacceptable reality in our country in terms of public health."[73]

There is good observational evidence that smoke-free legislation reduces the number of hospitaladmissions for heart disease.[74]In 2009 two studies in the United States confirmed theeffectiveness of public smoking bans in preventing heart attacks. The first study, carried out atthe University of California, San Francisco and funded by the National Cancer Institute, found a15 percent decline in heart-attack hospitalisations in the first year after smoke-free legislationwas passed, and 36 percent after three years.[75]The second study, carried out at the University ofKansas School of Medicine, showed similar results.[76]Overall, women, non-smokers, andpeople under age 60 had the most heart attack risk reduction. Many of those benefiting werehospitality and entertainment industry workers.[77]

Risk level

TheInternational Agency for Research on Cancerof theWorld Health Organizationconcludedin 2004 that there was sufficient evidence that second-hand smoke caused cancer in humans.[3]Most experts conclude that moderate, occasional exposure to second-hand smoke presents amodest but measurable cancer risk to nonsmokers. The overall risk depends on the effective dosereceived over time. The risk level is higher if non-smokers spend many hours in an environmentwhere cigarette smoke is widespread, such as a business where many employees or patrons aresmoking throughout the day, or a residential care facility where residents smoke freely.[78]TheUS Surgeon General,in his 2006 report, estimated that living or working in a place wheresmoking is permitted increases the non-smokers' risk of developing heart disease by 2530% andlung cancer by 2030%.

Biomarkers
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Breath CO monitor displaying carbon monoxide concentration of an exhaled breath sample (in ppm)

with corresponding percent concentration of carboxyhemoglobin displayed below.

Environmental tobacco smoke can be evaluated either by directly measuring tobacco smokepollutants found in the air or by using biomarkers, an indirect measure of exposure.Carbonmonoxidemonitored through breath,nicotine,cotinine,thiocyanates,and proteins are the most

specific biological markers of tobacco smoke exposure.[79][80]

Biochemical tests are a much morereliable biomarker of second-hand smoke exposure than surveys. Certain groups of people arereluctant to disclose their smoking status and exposure to tobacco smoke, especially pregnantwomen and parents of young children. This is due to their smoking being socially unacceptable.Also, it may be difficult for individuals to recall their exposure to tobacco smoke.[81]

A 2007 study in the Addictive Behaviors Journal found a positive correlation between second-hand tobacco smoke exposure and concentrations of nicotine and/or biomarkers of nicotine in thebody. Significant biological levels of nicotine from second-hand smoke exposure wereequivalent to nicotine levels from active smoking and levels that are associated with behaviourchanges due to nicotine consumption.[82]

Cotinine

Cotinine,the metabolite of nicotine, is a biomarker of second-hand smoke exposure. Typically,cotinine is measured in the blood, saliva, and urine. Hair analysis has recently become a new,noninvasive measurement technique. Cotinine accumulates in hair during hair growth, whichresults in a measure of long-term, cumulative exposure to tobacco smoke.[83]Urinary cotininelevels have been a reliable biomarker of tobacco exposure and have been used as a reference in
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many epidemiological studies. However, cotinine levels found in the urine only reflect exposureover the preceding 48 hours. Cotinine levels of the skin, such as the hair and nails, reflecttobacco exposure over the previous three months and are a more reliable biomarker.[79]

Carbon monoxide (CO)

Carbon monoxide monitored via breathis also a reliable biomarker of second-hand smokeexposure as well as tobacco use. With high sensitivity and specificity, it not only provides anaccurate measure, but the test is also non-invasive, highly reproducible, and low in cost. BreathCO monitoring measures the concentration of CO in an exhalation inparts per million,and thiscan be directly correlated to the blood CO concentration (carboxyhemoglobin).[84]Breath COmonitors can also be used by emergency services to identify patients who are suspected ofhaving CO poisoning.

Pathophysiology

A 2004 study by theInternational Agency for Research on Cancerof theWorld HealthOrganizationconcluded that non-smokers are exposed to the same carcinogens as activesmokers.Sidestream smokecontains more than 4,000 chemicals, including 69 knowncarcinogens. Of special concern arepolynuclear aromatic hydrocarbons,tobacco-specific N-nitrosamines,andaromatic amines,such as4-aminobiphenyl,all known to be highlycarcinogenic. Mainstream smoke, sidestream smoke, and second-hand smoke contain largely thesame components, however the concentration varies depending on type of smoke.[3]Severalwell-establishedcarcinogenshave been shown by the tobacco companies' own research to bepresent at higher concentrations in sidestream smoke than in mainstream smoke.[85]

Second-hand smoke has been shown to produce more particulate-matter (PM) pollution than an

idling low-emissiondiesel engine.In an experiment conducted by the Italian National CancerInstitute, three cigarettes were leftsmoldering,one after the other, in a 60 m garage with alimited air exchange. The cigarettes produced PM pollution exceeding outdoor limits, as well asPM concentrations up to 10-fold that of the idling engine.[86]

Tobacco smoke exposure has immediate and substantial effects on blood and blood vessels in away that increases the risk of a heart attack, particularly in people already at risk.[87]Exposure totobacco smoke for 30 minutes significantly reduces coronary flow velocity reserve in healthynonsmokers.[88]

Pulmonary emphysema can be induced in rats through acute exposure to sidestream tobacco

smoke (30 cigarettes per day) over a period of 45 days.[89]Degranulation ofmast cellscontributing to lung damage has also been observed.[90]

The term "third-hand smoke"was recently coined to identify the residual tobacco smokecontamination that remains after the cigarette is extinguished and second-hand smoke has clearedfrom the air.[91][92][93]Preliminary research suggests that by-products of third-hand smoke maypose a health risk,[94]though the magnitude of risk, if any, remains unknown. In October 2011, itwas reported that Christus St. Frances Cabrini Hospital inAlexandria, Louisianawould seek to
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eliminate third-hand smoke beginning in July 2012, and that employees whose clothing smelledof smoke would not be allowed to work. This prohibition was enacted because third-hand smokeposes a special danger for the developing brains of infants and small children.[95]

In 2008, there were more than 161,000 deaths attributed to lung cancer in the United States. Of

these deaths, an estimated 10% to 15% were caused by factors other than first-hand smoking;equivalent to 16,000 to 24,000 deaths annually. Slightly more than half of the lung cancer deathscaused by factors other than first-hand smoking were found in nonsmokers. Lung cancer in non-smokers may well be considered one of the most common cancer mortalities in the United States.Clinical epidemiology of lung cancer has linked the primary factors closely tied to lung cancer innon-smokers as exposure to second-hand tobacco smoke, carcinogens including radon, and otherindoor air pollutants.[96]

Opinion of public health authorities

There is widespreadscientific consensusthat exposure to second-hand smoke is harmful.[4]The

link between passive smoking and health risks is accepted by every major medical and scientificorganisation, including:

TheWorld Health Organization:[3]

The governments of 168 nations have signed and currently

174 haveratifiedtheWorld Health Organization Framework Convention on Tobacco Control,

which states that "Parties recognize that scientific evidence has unequivocally established that

exposure to tobacco smoke causes death, disease and disability."[1]

The U.S.National Institutes of Health[97]

TheCenters for Disease Control[98]

TheUnited States Surgeon General[2]

The U.S.National Cancer Institute[99]

TheUnited States Environmental Protection Agency[100]

TheCalifornia Environmental Protection Agency

[8]

TheAmerican Heart Association,[101]

American Lung Association,[102]

andAmerican Cancer

Society[103]

TheAmerican Medical Association[104]

TheAmerican Academy of Pediatrics[105]

The AustralianNational Health and Medical Research Council[106]

TheUnited KingdomScientific Committee on Tobacco and Health[107]

Public opinion

Recent major surveys conducted by the U.S.National Cancer InstituteandCenters for DiseaseControlhave found widespread public awareness that second-hand smoke is harmful. In both1992 and 2000 surveys, more than 80% of respondents agreed with the statement that second-hand smoke was harmful. A 2001 study found that 95% of adults agreed that second-hand smokewas harmful to children, and 96% considered tobacco-industry claims that second-hand smokewas not harmful to be untruthful.[108]
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ikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-108http://en.wikipedia.org/wiki/Passive_smoking#cite_note-108http://en.wikipedia.org/wiki/Passive_smoking#cite_note-108http://en.wikipedia.org/wiki/Passive_smoking#cite_note-108http://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-107http://en.wikipedia.org/wiki/United_Kingdomhttp://en.wikipedia.org/wiki/National_Health_and_Medical_Research_Councilhttp://en.wikipedia.org/wiki/National_Health_and_Medical_Research_Councilhttp://en.wikipedia.org/wiki/American_Academy_of_Pediatricshttp://en.wikipedia.org/wiki/American_Academy_of_Pediatricshttp://en.wikipedia.org/wiki/American_Medical_Associationhttp://en.wikipedia.org/wiki/American_Medical_Associationhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-103http://en.wikipedia.org/wiki/American_Cancer_Societyhttp://en.wikipedia.org/wiki/American_Cancer_Societyhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-102http://en.wikipedia.org/wiki/American_Lung_Associationhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-101http://en.wikipedia.org/wiki/American_Heart_Associationhttp://en.wikipedia.org/wiki/California_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/California_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/United_States_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/United_States_Environmental_Protection_Agencyhttp://en.wikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/National_Cancer_Institutehttp://en.wikipedia.org/wiki/United_States_Surgeon_Generalhttp://en.wikipedia.org/wiki/United_States_Surgeon_Generalhttp://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/Centers_for_Disease_Controlhttp://en.wikipedia.org/wiki/National_Institutes_of_Healthhttp://en.wikipedia.org/wiki/National_Institutes_of_Healthhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-framework-treaty-1http://en.wikipedia.org/wiki/World_Health_Organization_Framework_Convention_on_Tobacco_Controlhttp://en.wikipedia.org/wiki/Ratificationhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-IARC2004-3http://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-kessler-4http://en.wikipedia.org/wiki/Scientific_consensushttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-96http://en.wikipedia.org/wiki/Passive_smoking#cite_note-95


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A 2007Gallup pollfound that 56% of respondents felt that second-hand smoke was "veryharmful", a number that has held relatively steady since 1997. Another 29% believe that second-hand smoke is "somewhat harmful"; 10% answered "not too harmful", while 5% said "not at allharmful".[citation needed]

Controversy over harm

As part of its attempt to prevent or delay tighter regulation of smoking, the tobacco industryfunded a number of scientific studies and, where the results cast doubt on the risks associatedwith second-hand smoke, sought wide publicity for those results. The industry also fundedlibertarian and conservative think tanks, such as theCato Institutein the United States and theInstitute of Public Affairsin Australia which criticised both scientific research on passivesmoking and policy proposals to restrict smoking.[109][110]New Scientistand theEuropeanJournal of Public Healthhave identified these industry-wide coordinated activities as one of theearliest expressions ofcorporate denialism.Further, they state that the disinformation spread bythe tobacco industry has created a tobacco denialismmovement, sharing many characteristics of

other forms ofdenialism,such asHIV-AIDS denialism.[111][112]

Industry-funded studies and critiques

Enstrom and Kabat

A 2003 study by Enstrom and Kabat, published in theBritish Medical Journal,argued that theharms of passive smoking had been overstated.[113]Their analysis reported no statisticallysignificant relationship between passive smoking and lung cancer, though the accompanyingeditorial noted that "they may overemphasise the negative nature of their findings."[114]Thispaper was widely promoted by the tobacco industry as evidence that the harms of passive

smoking were unproven.[115][116]TheAmerican Cancer Society(ACS), whose database Enstromand Kabat used to compile their data, criticized the paper as "neither reliable nor independent",stating that scientists at the ACS had repeatedly pointed out serious flaws in Enstrom and Kabat'smethodology prior to publication.[117]Notably, the study had failed to identify a comparisongroup of "unexposed" persons.[118]

Enstrom's ties to the tobacco industry also drew scrutiny; in a 1997 letter toPhilip Morris,Enstrom requested a "substantial research commitment... in order for me to effectively competeagainst the large mountain of epidemiologic data and opinions that already exist regarding thehealth effects of ETS and active smoking."[119]In aUS racketeering lawsuit against tobaccocompanies,the Enstrom and Kabat paper was cited by the US District Court as "a prime example

of how nine tobacco companies engaged in criminal racketeering and fraud to hide the dangersof tobacco smoke."[120]The Court found that the study had been funded and managed by theCenter for Indoor Air Research,[121]a tobacco industryfront grouptasked with "offsetting"damaging studies on passive smoking, as well as by Phillip Morris[122]who stated that Enstrom'swork was "clearly litigation-oriented."[123]Enstrom has defended the accuracy of his studyagainst what he terms "illegitimate criticism by those who have attempted to suppress anddiscredit it."[124]
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oking#cite_note-acsresponse-117http://en.wikipedia.org/wiki/American_Cancer_Societyhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-115http://en.wikipedia.org/wiki/Passive_smoking#cite_note-115http://en.wikipedia.org/wiki/Passive_smoking#cite_note-114http://en.wikipedia.org/wiki/Passive_smoking#cite_note-113http://en.wikipedia.org/wiki/British_Medical_Journalhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-111http://en.wikipedia.org/wiki/Passive_smoking#cite_note-111http://en.wikipedia.org/wiki/AIDS_denialismhttp://en.wikipedia.org/wiki/Denialismhttp://en.wikipedia.org/wiki/Denialism#Corporate_denialismhttp://en.wikipedia.org/wiki/Passive_smoking#cite_note-109http://en.wikipedia.org/wiki/Passive_smoking#cite_note-109http://en.wikipedia.org/wiki/Institute_of_Public_Affairshttp://en.wikipedia.org/wiki/Cato_Institutehttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Gallup_poll


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Gori

Gio Batta Gori,a tobacco industry spokesman and consultant[125][126][127]and an expert on riskutility and scientific research, wrote in thelibertarianCato Institute's journalRegulationthat"...of the 75 published studies of ETS and lung cancer, some 70 percent did not report

statistically significant differences of risk and are moot. Roughly 17 percent claim an increasedrisk and 13 percent imply a reduction of risk."[128]

Milloy

Steven Milloy,the "junk science"commentator forFox Newsand a formerPhilip Morrisconsultant,[129][130]claimed that "of the 19 studies" on passive smoking "only 8slightly morethan 42 percentreported statistically significant increases in heart disease incidence.."[131]

Another component of criticism cited by Milloy focused onrelative riskand epidemiologicalpractices in studies of passive smoking. Milloy, who has a masters degree from the Johns

Hopkins School of Hygiene and Public Health, argued that studies yielding relative risks of lessthan 2 were meaningless junk science. This approach to epidemiological analysis was criticizedin theAmerican Journal of Public Health:

A major component of the industry attack was the mounting of a campaign to establish a "bar"for "sound science" that could not be fully met by most individual investigations, leaving studiesthat did not meet the criteria to be dismissed as "junk science."[132]

The tobacco industry and affiliated scientists also put forward a set of "Good EpidemiologyPractices" which would have the practical effect of obscuring the link between secondhandsmoke and lung cancer; the privately stated goal of these standards was to "impede adverse

legislation".[133]

However, this effort was largely abandoned when it became clear that noindependent epidemiological organization would agree to the standards proposed by PhilipMorris et al.[134]

World Health Organization controversy

A 1998 report by theInternational Agency for Research on Cancer(IARC) on environmentaltobacco smoke (ETS) found "weak evidence of a dose-response relationship between risk of lungcancer and exposure to spousal and workplace ETS."[78]

In March 1998, before the study was published, reports appeared in the media alleging that the

IARC and theWorld Health Organization(WHO) were suppressing information. The reports,appearing in the BritishSunday Telegraph[135]andThe Economist,[136]among othersources,[137][138][139]alleged that the WHO withheld from publication of its o

Documents

Passive Smoker Speech