INSIDE

Health Matters

By Virginia Lester,
RN, MSN, ARNP

There have been few epidemics as devastating and preventable as that caused by tobacco consumption. Cigarette smoking became highly prevalent in most developed countries through the 20th century.

After a lag of several decades, by the middle of the century, the rise of smoking was followed by epidemic increases in diseases. Scientific studies were producing evidence that smoking caused diseases.

Unfortunately, we have begun the 21st century with smoking on the rise especially in developing countries.

The issue of secondhand smoke (SHS) and health has a much briefer history even though the irritating nature of tobacco smoke to the nonsmoker has long been reported. While we may be aware that smoking causes over 400,000 deaths each year, the scientific evidence on the health risks associated with exposure to secondhand smoke is more recent but the evidence is clear, convincing and overwhelming.
The 2006 U.S. surgeon general’s report leaves no doubt that any exposure to tobacco smoke is harmful to human health. The findings on secondhand smoke and disease have been the foundation of the drive for smoke-free indoor environments and for educating parents concerning the effects of their smoking on their children’s health.

The definition of secondhand smoke is the involuntary exposure of nonsmokers to tobacco smoke from the smoking of others.  At present, 1.3 billion adults worldwide are smokers, implying that SHS exposure is almost unavoidable for children and adults who do not smoke.

Exposure to SHS causes over 38,000 deaths from cancer, increases the risk for heart disease among non-smokers by as much as 60 percent and increases the risk of stroke by 50 percent.

More importantly, over one million illnesses in children are caused by SHS: slightly reduced birth weight, lower respiratory illnesses, chronic respiratory symptoms, middle ear disease, reduced lung function, asthma and sudden infant death syndrome. SHS places the overall normal growth and development at risk and impairs a child’s ability to learn. SHS is neurotoxic and even at low levels more than 22 million children are estimated to have reading deficits. As the exposure levels increase there are deficits in math and visual spatial reasoning.

In environments where smoking is permitted, components of tobacco smoke can be readily measured in the air, including small particles in the size range that penetrates into the lung such as carbon monoxide, nicotine and benzene. The secondhand smoker inhales all these components of tobacco.

Benzene, a known cause of leukemia, is generated by tobacco combustion and may contribute to the increased risk of leukemia. SHS is one of the major sources of benzene exposure for nonsmokers, making a contribution to exposure that rivals that from filling a car with gasoline. Cotinine, the principal metabolite of nicotine, can be measured in the blood of nonsmokers.

Fifty to 75 percent of children in the U.S. have detectable levels of cotinine. Twenty-one million or 35 percent of children live in homes where residents or visitors smoke on a regular basis. The surgeon general’s report concluded that scientific evidence indicates there is no risk-free level of exposure to SHS.

Three cigarettes smoldering in a room emits more particulates than a diesel engine and may account for more respiratory damage and asthma. For every eight smokers the tobacco industry kills, it takes one non-smoker with them.