Sunday, January 30, 2011

How Dangerous Is Secondhand Smoke?

Secondhand smoke is a burning health issue, thanks to two new major studies. Find out how to protect yourself and your family from this insidious killer...

Everyone knows smoking is dangerous – 1 in 10 deaths worldwide is from a smoking-related disease, according to the World Health Organization.

But exposure to tobacco fumes kills 600,000 nonsmokers a year worldwide, including 165,000 children, according to a December 2010 WHO study. That’s about 1 out of every 100 deaths worldwide, through smoke-related illnesses such as heart disease, lower respiratory infections, asthma and lung cancer.

And the fumes are harder to avoid than you think: They can seep through apartment ventilation systems and cling to baby car seats, where they’re easily ingested.

The U.S. Surgeon General’s office issued its own smoking report in December, reinforcing the dangers of “passive,” or secondhand, exposure.

“Chemicals in tobacco smoke reach lungs quickly every time you inhale, causing damage immediately,” said U.S. Surgeon General Regina M. Benjamin, M.D.

“Inhaling even the smallest amount can also damage DNA, which can lead to cancer.”

About 3,400 lung cancer deaths a year are attributable to secondhand smoke, the report estimates.

Read on to learn more about secondhand smoking risks and how to limit exposure:

Why Other People’s Smoke Can Harm You
Tobacco smoke contains 7,000 chemicals, including hundreds that are toxic and at least 70 known to cause cancer, according to the Surgeon General’s report.

Passive exposure also causes heart attacks, says cardiologist Matthew Sorrentino, M.D., FAAC, an associate professor of medicine at the University of Chicago.

“The toxins in cigarette smoke enter the body and damage the coronary arteries that bring blood to the heart,” he says. “Cholesterol builds up on the arteries, and they become blocked, which can lead to a heart attack.”

The more you’re exposed, the higher your health risks.

“Someone who works in a bar or restaurant eight hours a day and is surrounded by smokers will have a higher exposure rate than most other people. The longtime spouse of a smoker will have a higher dose effect as well.”

Each year, 46,000 American nonsmokers who live with smokers die from heart disease, according to the Surgeon General’s report.

Demand Builds for Smoke-Free Environments
As concerns about secondhand smoke increase, so have calls for smoke-free homes, workplaces and public venues.

“The U.S. Surgeon General concluded that there’s no safe level of exposure to tobacco smoke,” says Joel London, a spokesperson for the Centers for Disease Control and Prevention (CDC) Office on Smoking and Health in Atlanta.

The District of Columbia and 25 states now have comprehensive anti-smoking laws that apply to various locales.

Efforts like these appear to be working: While the percentage of Americans who smoke has stayed relatively constant – 20.6% percent in 2009 – the percentage of nonsmokers exposed to secondhand smoke has dropped from 88% in 1988-‘91 to 40%, as of 2007-‘08.

Still, that 40% accounts for 88 million people. Kids are at even greater risk: More than half of American children ages 3-11 are exposed to tobacco toxins.

A national study of 5,000 children by the American Academy of Pediatrics is expected to add momentum to the call for smoke-free housing policies.

The report, published in the journal Pediatrics in 2010, examined exposure by measuring the kids’ levels of the tobacco biomarker cotinine. (This chemical is produced when the body metabolizes nicotine.)

Among the children who didn’t live with a smoker, those in multi-unit housing complexes had 45% higher cotinine levels than those in detached homes, the study found. Researchers theorized that smoke from other residences seeps in through walls or shared ventilation systems.
“This is a pretty dramatic illustration of why we need smoke-free policies in apartment buildings,” says Jonathan P. Winickoff, M.D., FAAP, a pediatrician at Massachusetts General Hospital for Children and senior author of the study.

Winickoff encourages apartment dwellers to lobby landlords for building-wide bans on smoking. In addition to health benefits for residents, they would reduce fire risk and lower the building’s clean-up and insurance costs, he adds.

Activists are pushing for smoke-free policies in other places too, such as airports, restaurants and bars. Of the nation’s 29 largest airports, 22 are now smoke-free – almost double the amount in 2001, according to CDC spokesperson London.

But millions of passengers are exposed in the seven major airports that still allow smoking – including those in Atlanta, Ga.; Dallas, Texas; and Denver, Colo.

As for other gathering places, “37% of the population isn’t covered by local and state clean-indoor-air laws for bars, and 26% of the population isn’t covered for restaurants,” says Cheryl G. Healton, president and CEO of Legacy, a national public health foundation in Washington, D.C.

These fumes don’t only affect customers. Food-service workers exposed to secondhand smoke also have a 50% increased risk of lung cancer, the foundation notes.

Support for Quitters
The most effective way to limit your tobacco exposure is to convince smokers around you to give up the habit, the experts say.

Your best bet: Encourage smokers to enter an organized cessation program that includes a coordinator to monitor progress. Less than 20% of smokers are able to quit on their own, but these programs increase success rates to nearly half, says Sorrentino.

Other popular stop-smoking aids include nicotine patches, gum, hypnosis and prescription medicines. Call 800-QUIT-Now to find resources in your area.

While quitting can’t mitigate damage already caused by smoking, it offers almost immediate health benefits.

“The risk of having a stroke or heart attack because of past smoking dissipates pretty quickly, within a year or two of quitting,” Sorrentino says.
How to Limit Exposure
While avoiding tobacco smoke completely can be difficult – especially if one or more people you live with refuse to quit – there are steps you can take to limit exposure, Winickoff says.

Here are his suggestions:

1. Don’t allow smoking in your home or vehicle. Some smokers assume that running a fan or opening windows can prevent negative effects of secondhand smoke.

They’re wrong. The fumes can still be inhaled by others, and they leave a residue of invisible toxins that cling to hair, clothing, carpeting and fabric – something Winickoff and other researchers refer to as thirdhand smoke.

Wiping surfaces clean doesn’t fully eradicate this harmful residue.

“Babies will touch their car seats, then bring their hands to their mouths. In the process, they ingest the toxins of tobacco smoke,” Winickoff says.

2. Stop workplace smoking. Insist that smokers leave the building to light up, and ask managers to offer incentive programs to help employees quit. Some companies offer cash, gift certificates, stop-smoking medication or counseling to help coworkers kick the habit.

“When employers encourage staff to stop smoking, they see fewer breaks, lower incidences of heart disease and no asthma events,” Winickoff says.

3. Choose smoke-free child care and senior programs. Children and the elderly are particularly vulnerable to secondhand toxins and may be less able to get away from the source of the smoke.

Hire non-smoking babysitters and senior aides, too, Winickoff suggests.

4. Patronize businesses with no-smoking policies. In addition to avoiding exposure, it shows other establishments that going smoke-free is a good business practice.

Several hotel chains, including Westin, Heartland Inns and all of the Marriott brands, now have smoke-free policies.

5. Avoid smoke as much as possible. “A single molecule of [smoke component] benzene can affect DNA and cause mutations,” Winickoff says.

The CDC’s London is optimistic that these policies will continue to take hold in venues across the country, noting that more states are enacting public anti-smoking laws.

“After the 2006 Surgeon General’s report on the impact of secondhand smoke was released, there was a groundswell of support for smoke-free policies,” he says.

The newly released 2010 report should yield even more positive results, he says, particularly as more secondhand-smoke-related risks come to light.

Other Dangers of Secondhand Smoke
Cancer and heart disease aren’t the only health problems associated with secondhand smoke. Recent studies link it to several other issues affecting kids and adults alike. Here are just a few:

Asthma and respiratory problems lead the list of smoke-related health dangers for kids, Sorrentino says. Between 200,000 and 1 million asthmatic children in the U.S. have aggravated symptoms due to secondhand smoke, according to the Environmental Protection Agency.

Preschool children are likely to have higher blood pressure if their parents smoke, according to a 2011 German study published in the journal Circulation.

Earlier studies have linked secondhand smoke with Sudden Infant Death Syndrome (SIDS), low birth weight and learning disabilities.

In households with secondhand smoke, kids age 12-17 are 1.67 times more prone to recurrent ear infections than those in a smoke-free environment, according to a 2010 Harvard study. Parents often smoke indoors more as children grow older, the study also found.

There are 20 known or suspected mammary carcinogens in tobacco smoke. A lifetime of either smoking or exposure to secondhand smoke “about doubled the risk of premenopausal breast cancer,” according to 2010 research by an expert panel of Canadian researchers reviewing past studies.
Nonsmokers with heavy exposure to secondhand smoke have higher odds of psychological distress, according to a 2010 British study published in Archives of General Psychiatry. Over a six-year follow-up, they were more likely to be hospitalized for depression, schizophrenia, delirium or other psychiatric conditions.

About 40% of all cases of chronic sinus disease appear to have been caused by smoke exposure, according to a 2010 Canadian study published in the Archives of Otolaryngology-Head & Neck Surgery.

Are You Ready to Quit Smoking?
By now you should know that smoking increases your risk for heart disease, lung cancer, stroke and more.

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