The Health Consequences of Secondhand Smoke (Involuntary Exposure to Tobacco Smoke)

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1 The Health Cnsequences f Secndhand Smke (Invluntary Expsure t Tbacc Smke) What Is Secndhand Smke? Secndhand smke is cmpsed f sidestream smke (the smke released frm the burning end f a cigarette) and exhaled mainstream smke (the smke exhaled by the smker). While secndhand smke has been referred t as envirnmental tbacc smke (ETS) in the past, the term secndhand smke better captures the invluntary nature f the expsure. The 2006 Surgen General s reprt uses the term invluntary in the title because mst nnsmkers d nt want t breathe tbacc smke. The term invluntary was als used in the title f the 1986 Surgen General s reprt n secndhand smke. Cigarette smke cntains mre than 4,000 chemical cmpunds. Secndhand smke cntains many f the same chemicals that are present in the smke inhaled by smkers. Because sidestream smke is generated at lwer temperatures and under different cnditins than mainstream smke, it cntains higher cncentratins f many f the txins fund in cigarette smke. The Natinal Txiclgy Prgram estimates that at least 250 chemicals in secndhand smke are knwn t be txic r carcingenic. Secndhand smke has been designated as a knwn human carcingen (cancer causing agent) by the U.S. Envirnmental Prtectin Agency, the Natinal Txiclgy Prgram, and the Internatinal Agency fr Research n Cancer, and an ccupatinal carcingen by the Natinal Institute fr Occupatinal Safety and Health. Secndhand smke cntains mre than 50 cancer causing chemicals. When nnsmkers are expsed t secndhand smke, they inhale many f the same cancer causing chemicals that smkers inhale. The Surgen General has cncluded that: There is n risk free level f expsure t secndhand smke: even small amunts f secndhand smke expsure can be harmful t peple s health. Many millins f Americans cntinue t be expsed t secndhand smke. A smke free envirnment is the nly way t fully prtect nnsmkers frm the dangers f secndhand smke. Separating smkers frm nnsmkers, cleaning the air, and ventilating buildings cannt eliminate expsure f nnsmkers t secndhand smke. 6 Majr Cnclusins f the Surgen General Reprt Smking is the single greatest avidable cause f disease and death. In this reprt, The Health Cnsequences f Invluntary Expsure t Tbacc Smke: A Reprt f the Surgen General, the Surgen General has cncluded that: 1. Many millins f Americans, bth children and adults, are still expsed t secndhand smke in their hmes and wrkplaces despite substantial prgress in tbacc cntrl. Supprting Evidence Levels f a chemical called ctinine, a bimarker f secndhand smke expsure, fell by 70 percent frm t In natinal surveys, hwever, 43 percent f U.S. nnsmkers still have detectable levels f ctinine.

2 Almst 60 percent f U.S. children aged 3 11 years r almst 22 millin children are expsed t secndhand smke. Apprximately 30 percent f indr wrkers in the United States are nt cvered by smke free wrkplace plicies. 2. Secndhand smke expsure causes disease and premature death in children and adults wh d nt smke. Supprting Evidence Secndhand smke cntains hundreds f chemicals knwn t be txic r carcingenic (cancer causing), including frmaldehyde, benzene, vinyl chlride, arsenic, ammnia, and hydrgen cyanide. Secndhand smke has been designated as a knwn human carcingen (cancer causing agent) by the U.S. Envirnmental Prtectin Agency, Natinal Txiclgy Prgram and the Internatinal Agency fr Research n Cancer (IARC). The Natinal Institute fr Occupatinal Safety and Health has cncluded that secndhand smke is an ccupatinal carcingen. 3. Children expsed t secndhand smke are at an increased risk fr sudden infant death syndrme (SIDS), acute respiratry infectins, ear prblems, and mre severe asthma. Smking by parents causes respiratry symptms and slws lung grwth in their children. Supprting Evidence Children wh are expsed t secndhand smke are inhaling many f the same cancer causing substances and pisns as smkers. Because their bdies are develping, infants and yung children are especially vulnerable t the pisns in secndhand smke. Bth babies whse mthers smke while pregnant and babies wh are expsed t secndhand smke after birth are mre likely t die frm sudden infant death syndrme (SIDS) than babies wh are nt expsed t cigarette smke. Babies whse mthers smke while pregnant r wh are expsed t secndhand smke after birth have weaker lungs than unexpsed babies, which increases the risk fr many health prblems. Amng infants and children, secndhand smke cause brnchitis and pneumnia, and increases the risk f ear infectins. Secndhand smke expsure can cause children wh already have asthma t experience mre frequent and severe attacks. 4. Expsure f adults t secndhand smke has immediate adverse effects n the cardivascular system and causes crnary heart disease and lung cancer. Supprting Evidence Cncentratins f many cancer causing and txic chemicals are higher in secndhand smke than in the smke inhaled by smkers. Breathing secndhand smke fr even a shrt time can have immediate adverse effects n the cardivascular system and interferes with the nrmal functining f the heart, bld, and vascular systems in ways that increase the risk f a heart attack.

3 Nnsmkers wh are expsed t secndhand smke at hme r at wrk increase their risk f develping heart disease by percent. Nnsmkers wh are expsed t secndhand smke at hme r at wrk increase their risk f develping lung cancer by percent. 5. The scientific evidence indicates that there is n risk free level f expsure t secndhand smke. Supprting Evidence Shrt expsures t secndhand smke can cause bld platelets t becme stickier, damage the lining f bld vessels, decrease crnary flw velcity reserves, and reduce heart rate variability, ptentially increasing the risk f a heart attack. Secndhand smke cntains many chemicals that can quickly irritate and damage the lining f the airways. Even brief expsure can result in upper airway changes in healthy persns and can lead t mre frequent and mre asthma attacks in children wh already have asthma. 6. Eliminating smking in indr spaces fully prtects nnsmkers frm expsure t secndhand smke. Separating smkers frm nnsmkers, cleaning the air, and ventilating buildings cannt eliminate expsures f nnsmkers t secndhand smke. Supprting Evidence Cnventinal air cleaning systems can remve large particles, but nt the smaller particles r the gases fund in secndhand smke. Rutine peratin f a heating, ventilating, and air cnditining system can distribute secndhand smke thrughut a building. The American Sciety f Heating, Refrigerating and Air Cnditining Engineers (ASHRAE), the preeminent U.S. bdy n ventilatin issues, has cncluded that ventilatin technlgy cannt be relied n t cntrl health risks frm secndhand smke expsure. Secndhand Smke Is Txic and Pisnus The Natinal Txiclgy Prgram estimates that at least 250 chemicals in secndhand smke are knwn t be txic r carcingenic (cancer causing). Secndhand smke cntains a number f pisnus gases and chemicals, including hydrgen cyanide (used in chemical weapns), carbn mnxide (fund in car exhaust), butane (used in lighter fluid), ammnia (used in husehld cleaners), and tluene (fund in paint thinners). Sme f the txic metals cntained in secndhand smke include arsenic (used in pesticides), lead (frmerly fund in paint), chrmium (used t make steel), and cadmium (used t make batteries). There are mre than 50 cancer-causing chemicals in secndhand smke that fall int different chemical classes, including: Plynuclear armatic hydrcarbns (PAHs) (such as Benz[a]pyrene) N Nitrsamines (such as tbacc specific nitrsamines) Armatic amines (such as 4 aminbiphenyl) Aldehydes (such as frmaldehyde) Miscellaneus rganic chemicals (such as benzene and vinyl chlride) and Inrganic cmpunds (such as thse cntaining metals like arsenic, beryllium, cadmium, lead, nickel and radiactive plnium 210).

4 Eleven cmpunds in tbacc smke (2-naphthylamine, 4-aminbiphenyl, benzene, vinyl chlride, ethylene xide, arsenic, beryllium, nickel cmpunds, chrmium, cadmium and plnium-210) have been identified by the Internatinal Agency fr Research n Cancer as Grup 1 (knwn human carcingen) carcingens. Secndhand smke has been designated as a knwn human carcingen (cancer-causing agent) by the U.S. Envirnmental Prtectin Agency, Natinal Txiclgy Prgram and the Internatinal Agency fr Research n Cancer (IARC). The Natinal Institute fr Occupatinal Safety and Health has cncluded that secndhand smke is an ccupatinal carcingen. Secndhand smke is cmpsed f sidestream smke (the smke released frm the burning end f a cigarette) and exhaled mainstream smke (the smke exhaled by the smker). Because sidestream smke is generated at lwer temperatures and under different cnditins than mainstream smke, it cntains higher cncentratins f many f the txins fund in inhaled cigarette smke. There is N Risk Free Level f Expsure t Secndhand Smke The U.S. Surgen General has cncluded that breathing even a little secndhand smke pses a risk t yur health. Scientific evidence indicates that there is n risk free level f expsure t secndhand smke. Breathing even a little secndhand smke can be harmful t yur health. Secndhand smke causes lung cancer. Secndhand smke is a knwn human carcingen and cntains mre than 50 chemicals that can cause cancer. Cncentratins f many cancer causing and txic chemicals are ptentially higher in secndhand smke than in the smke inhaled by smkers. Secndhand smke causes heart disease. Breathing secndhand smke fr even a shrt time can have immediate adverse effects n the cardivascular system, interfering with the nrmal functining f the heart, bld, and vascular systems in ways that increase the risk f heart attack. Even a shrt time in a smky rm can cause yur bld platelets t becme stickier, damage the lining f bld vessels, decrease crnary flw velcity reserves, and reduce heart rate variability. Persns wh already have heart disease are at especially high risk f suffering adverse affects frm breathing secndhand smke, and shuld take special precautins t avid even brief expsure. Secndhand smke causes acute respiratry effects. Secndhand smke cntains many chemicals that can quickly irritate and damage the lining f the airways. Even brief expsure can trigger respiratry symptms, including cugh, phlegm, wheezing, and breathlessness. Brief expsure t secndhand smke can trigger an asthma attack in children with asthma. Persns wh already have asthma r ther respiratry cnditins are at especially high risk fr being affected by secndhand smke, and shuld take special precautins t avid secndhand smke expsure. Secndhand smke can cause sudden infant death syndrme and ther health cnsequences in infants and children. Smking by wmen during pregnancy has been knwn fr sme time t cause SIDS. Infants wh are expsed t secndhand smke after birth are als at greater risk f SIDS.

5 Children expsed t secndhand smke are als at an increased risk fr acute respiratry infectins, ear prblems, and mre severe asthma. Smking by parents causes respiratry symptms and slws lung grwth in their children. Separating smkers frm nnsmkers, cleaning the air, and ventilating buildings cannt eliminate secndhand smke expsure. The American Sciety f Heating, Refrigerating and Air Cnditining Engineers (ASHRAE), the preeminent U.S. standard setting bdy n ventilatin issues, has cncluded that ventilatin technlgy cannt be relied n t cmpletely cntrl health risks frm secndhand smke expsure. Cnventinal air cleaning systems can remve large particles, but nt the smaller particles r the gases fund in secndhand smke. Operatin f a heating, ventilating, and air cnditining system can distribute secndhand smke thrughut a building. Children are Hurt by Secndhand Smke Secndhand smke cntains mre than 250 chemicals knwn t be txic r carcingenic (cancer causing), including frmaldehyde, benzene, vinyl chlride, arsenic, ammnia, and hydrgen cyanide. Children wh are expsed t secndhand smke are inhaling many f the same cancer causing substances and pisns as smkers. Health Effects f Secndhand Smke in Children Because their bdies are develping, infants and yung children are especially vulnerable t the pisns in secndhand smke. Bth babies whse mthers smke while pregnant and babies wh are expsed t secndhand smke after birth are mre likely t die frm sudden infant death syndrme (SIDS) than babies wh are nt expsed t cigarette smke. Mthers wh are expsed t secndhand smke while pregnant are mre likely t have lwer birth weight babies, which makes babies weaker and increases the risk fr many health prblems. Babies whse mthers smke while pregnant r wh are expsed t secndhand smke after birth have weaker lungs than ther babies, which increases the risk fr many health prblems. Secndhand smke expsure causes acute lwer respiratry infectins such as brnchitis and pneumnia in infants and yung children. Secndhand smke expsure causes children wh already have asthma t experience mre frequent and severe attacks. Secndhand smke expsure causes respiratry symptms, including cugh, phlegm, wheeze, and breathlessness, amng schl aged children. Children expsed t secndhand smke are at increased risk fr ear infectins and are mre likely t need an peratin t insert ear tubes fr drainage. Expsure t Secndhand Smke Amng Children The Surgen General has cncluded that there is n risk free level f secndhand smke expsure. Even brief expsures can be harmful. On average, children are expsed t mre secndhand smke than nnsmking adults. Based n levels f ctinine (a bilgical marker f secndhand smke expsure), an estimated 22 millin children aged 3 11 years and 18 millin yuth aged years, were expsed t secndhand smke in the United States in Children aged 3 11 years and yuth aged years are significantly mre likely than adults t live in a husehld with at least ne smker.

6 Children aged 3 11 years have ctinine levels mre than twice as high as nnsmking adults. Children wh live in hmes where smking is allwed have higher ctinine levels than children wh live in hmes where smking is nt allwed. Hw t Prtect Yurself and Yur Lved Ones frm Secndhand Smke The Surgen General has cncluded that there is n risk free level f expsure t secndhand smke. Breathing even a little secndhand smke can be harmful. The Surgen General has cncluded that the nly way t fully prtect yurself and yur lved nes frm the dangers f secndhand smke is thrugh 100% smke free envirnments. Opening a windw, sitting in a separate area, r using ventilatin, air cnditining, r a fan cannt eliminate secndhand smke expsure. Yu can prtect yurself and yur lved nes by: Making yur hme and car smke free. Asking peple nt t smke arund yu and yur children. Making sure that yur children s day care center r schl is smke free. Chsing restaurants and ther businesses that are smke free. Thanking businesses fr being smkefree. Letting wners f businesses that are nt smke free knw that secndhand smke is harmful t yur family s health. Teaching children t stay away frm secndhand smke. Aviding secndhand smke expsure especially if yu r yur children have respiratry cnditins, if yu have heart disease, r if yu are pregnant. Talking t yur dctr r healthcare prvider mre abut the dangers f secndhand smke. If yu are a smker, the single best way t prtect yur family frm secndhand smke is t quit smking. In the meantime, yu can prtect yur family by making yur hme and vehicles smke free and nly smking utside. A smke free hme rule can als help yu quit smking. Jin the natinal trend. Take the Smke free Hme Pledge by calling the tll free Smke free Hme Pledge Htline at SMOKE FREE ( ) r visiting T access a telephne quitline serving yur area, call QUIT NOW ( ) r visit The Health Cnsequences f Invluntary Expsure t Tbacc Smke: A Reprt f the Surgen General was prepared by the Office n Smking and Health, Natinal Center fr Chrnic Disease Preventin and Health Prmtin, Centers fr Disease Cntrl and Preventin (CDC). The Reprt was written by 22 natinal experts wh were selected as primary authrs. The Reprt chapters were reviewed by 40 peer reviewers, and the entire Reprt was reviewed by 30 independent scientists and by lead scientists within the Centers fr Disease Cntrl and Preventin and the Department f Health and Human Services. Thrughut the review prcess, the Reprt was revised t address reviewers cmments. Citatin U.S. Department f Health and Human Services. The Health Cnsequences f Invluntary Expsure t Tbacc Smke: A Reprt f the Surgen General. U.S. Department f Health and Human Services, Centers fr Disease Cntrl and Preventin, Natinal Center fr Chrnic Disease Preventin and Health Prmtin, Office n Smking and Health, University f Miami Be Smke Free Smking Cessatin Prgram

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