PHA-Exchange> US Surgeon General Warns of Secondhand Smoke

[claudio at hcmc.netnam.vn]

 from Vern Weitzel <vern at coombs.anu.edu.au> -----

http://www.washingtonpost.com/wp-
dyn/content/article/2006/06/27/AR2006062700780.html

Surgeon General Warns of Secondhand Smoke

By JOHN O'NEIL
Published: June 27, 2006

Surgeon General Richard H. Carmona declared today that the evidence is 
now "indisputable" that 
secondhand smoke is an "alarming" public health hazard, and warned that 
measures like no-smoking 
sections don't provide adequate protection.


"Smoke-free environments are the only approach that protects nonsmokers from 
the dangers of 
secondhand smoke," he said.

Dr. Carmona did not call for a federal ban on smoking in workplaces, bars and 
restaurants, as a 
growing number of cities and states have done. He said he saw his role as 
providing the American 
people and Congress with definitive information on the subject.

"We hope that they will make the right decision on behalf of their 
constituents," Dr. Carmona said.

Smoking bans have often been bitterly resisted by business owners worried 
about losing customers and 
by groups skeptical about the dangers posed by secondhand smoke. But Dr. 
Carmona today said that 
"overwhelming" evidence showed that secondhand smoke is responsible for "tens 
of thousands" of 
premature deaths from heart disease and cancer among nonsmokers each year.

"I am here to say the debate is over: the science is clear," Dr. Carmona said 
at a televised news 
conference this morning, at which he released a report updating the original 
surgeon general's study 
of secondhand smoke in 1986.

In the years since then, hundreds of studies have indicated that the harm 
caused by secondhand smoke 
is far greater than earlier believed, he said. The report's findings include 
the following:

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

* For nonsmoking adults, exposure raises the risk of heart disease by 25 to 30 
percent and of cancer 
by 20 to 30 percent, and accounted for an estimated 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 an estimated 
430 deaths last year. The risk is elevated both 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 meant to remove smoke from a shared 
space.

* While exposure has declined, as many as 60 percent of nonsmokers show 
biological evidence of 
encountering secondhand smoke, and an estimated 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 — fell by 75 percent among adults, when samples taken between 
1999 and 2002 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 to move their smoking outside 
while they are trying 
to quit. "Make the home a smoke-free environment," he said.

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 report "groundbreaking" even though much of 
its information had 
been published in journal articles previously. Bringing it all together 
creates a persuasive case 
for smoking bans, she said.

But she said that many tobacco advocates would be hesitant about using it as a 
springboard to push 
for federal legislation creating smoke-free environments like those that have 
been adopted in many 
other countries and throughout most of Western Europe.

"The risk of approaching it nationally in this country is the extreme lobbying 
power that the 
tobacco industry has on the Hill," she said, and any national bill able to 
pass would likely be 
weaker than the bans adopted by municipalities.

The report issued today also went beyond the 1986 study by finding that 
evidence suggests possible 
links between secondhand smoking and some other cancers, including breast 
cancer, childhood cancer 
and nasal sinus cancer. It found no link to cervical cancer.

Earlier this year, the California Environmental Protection Agency issued a 
report that concluded 
that exposure to secondhand smoke was a cause of breast cancer.

The surgeon general's report also found a link between exposure to secondhand 
smoke by pregnant 
women and low birth weights for their children, and said that evidence 
suggests a possible link to 
premature delivery .



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