1. Health Effects of Secondhand Smoke (Environmental Tobacco Smoke)
Christopher Squier
Department of Oral Pathology,
University of Iowa,
Iowa City, USA

2. 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 don’t get the benefit of the filter!

3. Secondhand Smoke – why is it harmful? Because of where it goes
Into your lungs and then
into your bloodstream

4. Health Effects of Secondhand Smoke Heart 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)

5. Health Effects of Secondhand Smoke The 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 (i.e.70% over no exposure)
Why are the risks so similar when the exposure is so different?
This must be junk science!

6. Health Effects of Secondhand Smoke Cancer – 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: per year

7. Health Effects of Secondhand Smoke Not only death but disease- and much of this affects infants and children
Asthma ,000-26,000 cases per year
Bronchitis or Pneumonia , ,000 cases per year
Middle Ear Infection 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

8. Health Effects of Secondhand Smoke What 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

9. Health Effects of Secondhand Smoke What 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)

10. Health Effects of Secondhand Smoke What is the evidence
Health Effects of Secondhand Smoke What is the evidence? Some recent data
Helena
Montana
CDC
Atlanta

11. Reduced incidence of hospital admissions for myocardial infarction associated with public smoking ban: before and after study.
(Sargent, Shepard, and Glantz; British Medical J  2004;328: ) 

12. What are the cardiovascular risks of smoking?
TF Pechacek, S Babb, Centers for Disease Control and Prevention, Atlanta, GA
BMJ  2004;328:  
There is a direct relationship
between the risk of ischaemic
heart disease and number of
cigarettes smoked

13. How acute are the cardiovascular risks of secondhand smoke?
TF Pechacek, S Babb, Centers for Disease Control and Prevention, Atlanta, GA
BMJ  2004;328:  
Exposure to second-hand
smoke can pose acute risks
to those with pre-existing
coronary disease

14. The Fallacy of Ventilation
What can we do about second hand smoke?
The Fallacy of Ventilation
  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.

15. 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

16. Smokefree environments:
What can we do about second-hand smoke?
Smokefree environments:
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)

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