Secondhand smoke -- what's the problem?         

[NOV. 9, 2005]  BETHESDA, Ga. -- Tobacco use, including cigarette smoking, dramatically increases one's own risk of developing cancer and also endangers the health of others. Exposure to secondhand smoke -- also called environmental tobacco smoke -- significantly increases a nonsmoker's risk of developing lung and other cancers, in addition to other health problems, like decreased respiratory function and other respiratory diseases, eye and nasal irritation, heart disease, and stroke. Secondhand smoke is responsible for an estimated 38,000 deaths among nonsmokers each year, which includes 3,000 lung cancer deaths and 35,000 deaths due to heart disease, and is responsible for lower respiratory tract infections in an estimated 300,000 children each year.

When a person is exposed to secondhand smoke, they are actually exposed to two forms of smoke. Side-stream smoke is emitted between puffs of a burning cigarette, pipe or cigar, and mainstream smoke is exhaled by the smoker. This combination of smoke contains at least 60 cancer-causing agents, such as formaldehyde, benzopyrene and nitrosamines, as well as toxins such as nicotine and carbon dioxide.

Who is at risk?

Anyone who is exposed to secondhand smoke is at an increased risk for developing cancer or other related health problems. Pregnant women and children are considered to be at an even higher risk for the development of disease. For pregnant women, exposure may result in babies of low birth-weight or who are small for gestational age. In some cases, secondhand smoke exposure can even result in miscarriage. Secondhand smoke exposure contributes to many respiratory conditions among children, including increased respiratory tract infections, decreased lung function, asthma and middle ear infections. For very young children and infants, exposure raises the risk of sudden infant death syndrome. Additionally, secondhand smoke exposure can worsen existing pulmonary symptoms for people with asthma and chronic bronchitis as well as those with allergic conditions.

Can it be prevented?

Exposure to secondhand smoke is preventable. Through the continued implementation of clean indoor air policies aimed at eliminating secondhand smoke exposure in workplaces, restaurants and bars, and public spaces such as beaches and parks, there has been a significant reduction in the level of secondhand smoke exposure in shared environments. However, preventing secondhand smoke exposure within the home environment continues to present a challenge. Among children younger than 18 years, an estimated 22 percent are exposed to secondhand smoke in their homes. Efforts by the National Cancer Institute and other smoking cessation and prevention campaigns aim to reduce secondhand smoke within the home, especially in homes with children.

The bottom line

• Exposure to secondhand smoke significantly increases one's risk of developing lung cancer and numerous other health problems.
• The chemicals in smoke affect both smokers and others around them.
• Children and pregnant women are particularly vulnerable to the health risks of exposure to secondhand smoke.
• Secondhand smoke exposure is preventable and can be eliminated if appropriate actions are taken.

Case examples

Richard, a 42-year-old marketing executive, has been a smoker for 22 years. Dealing with the stress of his fast-paced job, Richard feels his smoking provides him with much-needed breaks throughout the day and the ability to relax in the evening at home. However, he is surprised when his youngest daughter, Madelyn, is having trouble breathing and is diagnosed with asthma. The family pediatrician explains that in addition to undermining his own health, Richard's smoking may have triggered Madelyn's asthma. Realizing the danger his behavior poses to himself and his family, Richard joins a support group and quits smoking.

Maryanne and Julia, two English professors at a local university, carpool to work to save gas and keep each other company during the commute. Julia has been a smoker since her teens but now smokes only in the car while she drives. Maryanne's father has recently been diagnosed with lung cancer, and she is acutely aware of the risks associated with smoking. Concerned about her own exposure to secondhand smoke, Maryanne compiles information from the Internet and the university library. She gives the resources to Julia and asks if she would be willing to stop smoking in the car. Julia, understanding the possible impact of her smoking on her own health and realizing that a carpool buddy is more important than her morning cigarette, decides to quit.

For more information:

Cancer Information Service
1 (800) 4-CANCER [1 [phone]]
www.cancer.gov

[National Cancer Institute]