NY Times article on 2nd hand smoke

A Warning on Hazards of Secondhand Smoke


By JOHN O'NEIL
Published: June 28, 2006
The evidence is now "indisputable" that secondhand smoke is an "alarming" public health hazard, responsible for tens of thousands of premature deaths among nonsmokers each year, Surgeon General Richard H. Carmona said yesterday.

Dr. Carmona warned that measures like no-smoking sections did not provide adequate protection, adding, "Smoke-free environments are the only approach that protects nonsmokers from the dangers of secondhand smoke."

He did not call for a federal ban on smoking in workplaces, bars or restaurants, a step that has been taken by a growing number of cities and states over the objections of business owners and of groups skeptical about the dangers of secondhand smoke. He said he saw his role as providing the public and Congress with definitive information on the subject.

"I am here to say the debate is over: the science is clear," Dr. Carmona said at a televised news conference, where he released a report updating the original surgeon general's study of secondhand smoke in 1986. Since then, hundreds of studies have indicated that the harm caused by secondhand smoke is far greater than earlier believed, he said. The report includes these findings:

¶There is no safe level of secondhand smoke, and even brief exposure can cause harm, especially for people suffering from heart or respiratory diseases.

¶For nonsmoking adults, exposure raises the risk of heart disease by 25 percent to 30 percent and of cancer by 20 percent to 30 percent. It accounted for 46,000 premature deaths from heart disease and 3,000 premature deaths from cancer last year.

¶Secondhand smoke is a cause of sudden infant death syndrome, or SIDS, accounting for 430 deaths last year. The risk is elevated for children whose mothers were exposed during pregnancy and for children exposed in their homes after birth.

¶The impact on the health and development of children is more severe than previously thought. "Children are especially vulnerable to the poisons in secondhand smoke," Dr. Carmona said.

¶Efforts to minimize the effect of secondhand smoke by separating smokers and nonsmokers are ineffective, as are ventilation systems in a shared space.

¶While exposure has declined, as many as 60 percent of nonsmokers show biological evidence of encountering secondhand smoke, and 22 percent of children are exposed to secondhand smoke in their homes.

Studies conducted by the Centers for Disease Control show that great progress has been made in reducing exposure, Dr. Carmona said. The amount of cotinine — the form nicotine takes after being metabolized — in blood samples fell by 75 percent among adults, according to specimens taken from 1999 to 2002 that were compared with samples taken a decade earlier.

But Dr. Carmona said more needed to be done, particularly to protect children. He urged parents who smoke not only to quit, but also to move their smoking outside while trying to quit. "Make the home a smoke-free environment," he said.

Tobacco companies say the risks of secondhand smoke are unproved and overstated. In a statement on its Web site, R. J. Reynolds says, "It seems unlikely that secondhand smoke presents any significant harm to otherwise healthy nonsmoking adults; and, given the extensive smoking bans and restrictions that have already been enacted, nonsmokers can easily avoid exposure to secondhand smoke."

A spokesman for the company, David Howard, said yesterday, "Bottom line, we believe adults should be able to patronize establishments that permit smoking if they choose to do so," according to The Associated Press.

Dr. Cheryl G. Healton, the president and chief executive of the American Legacy Foundation, a nonprofit group created to use settlement money from tobacco companies to educate young people about the dangers of tobacco, called the surgeon general's report "groundbreaking" even though much of its information had already been published in journal articles. Bringing it all together creates a persuasive case for smoking bans, Dr. Healton said.

The report is online at surgeongeneral.gov/library/secondhandsmoke/.