ASH: Summarizing the Deadly Effects of Secondhand Tobacco Smoke [02/24/06-1]

        As previously noted, the decision by Calabasas, California, to ban smoking in virtually all outdoor areas – including sidewalks, streets, restaurant patios, parking lots,  etc.  – creates a new paradigm.  Instead of smoking outdoors being the norm, with either no restrictions, or with restrictions only in certain areas (like parks, playgrounds, beaches, etc.), the new norm is no smoking.  Virtually the only exceptions will be small and isolated “smokers’ outposts” in remote sections of parking lots.
SEE: http://no-smoking.org/Feb06/02-22-06-1.html

        One reason of many for this new paradigm was growing evidence of just how harmful tobacco smoke pollution can be, even outdoors.  Here is a brief summary of just some of the scientific and medical research which ASH cited to the Calabasas City Council in helping to persuade it to adopt this unprecedented smoking ban.

        FIRST, we noted that careful scientific studies – based upon both highly accurate mathematical modeling techniques as well as actual real-life measurements – have shown that concentrations of secondhand tobacco smoke in many outdoor areas are often as high or higher than in some indoor areas.  Here we cited several published scientific studies.

        SECOND, ASH noted that the risks posed by such outdoor exposure, while small to most individuals, are well beyond generally accepted norms when large numbers of people are involuntarily exposed.  Here we cited, among other support, a major report by the California Air Resources Board which included numerous citations to published studies.

        THIRD, ASH explained that drifting tobacco smoke, even outdoors, can trigger asthmatic attacks, bronchial infections, and other serious health problems in nonsmokers. This is especially true for the almost 100 million Americans who have asthma, chronic bronchitis, chronic sinusitis, emphysema, and other breathing related conditions which make them especially susceptible to secondhand tobacco smoke. Here, in addition to a major survey, we cited several actual instances.

        FOURTH, ASH reported that even for some people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes ( less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker’s risk of suffering a fatal heart attack to that of a smoker.  Here, because the CDC report was so important, and many people were not aware of it, we cited numerous sources:

    A.  First, as the Washington Post reported it in an article entitled Secondhand Smoke Poses Heart Attack Risk, CDC Warns:  “The CDC disclosed its new advisory in a commentary to a study published in the British Medical Journal yesterday, saying doctors need to warn people with heart problems that secondhand smoke can significantly increase their risk of a heart attack. The agency said that as little as 30 minutes' exposure can have a serious and even lethal effect.”  Here ASH  highlighted certain words to emphasize how this respected news organization reported it, and how even a brief exposure can have a “lethal effect.”

    B. Similarly, the St. Louis Post-Dispatch warned in an article entitled Smoking Gun that: “The U.S. Centers for Disease Control and Prevention cautioned that secondhand smoke greatly increases the risk of heart attack for those with heart disease. For such people, even 30 minutes' exposure can be lethal, the government warns.” Again ASH highlighted certain words to make clear that this independent news organization also understood that a “lethal risk”  – i.e., the risk of death – could occur from “even 30 minutes’ exposure.”

    C. These and similar reports in dozens of major newspapers were based upon an article by two scientific officials from the Centers for Disease Control entitled How Acute and Reversible are the Cardiovascular Risks of Secondhand Smoke?  To be sure that the Calabasas City Council fully understood the import of this article, and did not simply rely upon ASH’s summary (which was virtually the same as that of many impartial media outlets), ASH included the following text from the article by these two CDC scientists.
    “Could eating in a smoky restaurant precipitate an acute myocardial infarction in a non-smoker? As unlikely as this sounds, a growing body of scientific data suggests that this is possible. In this context, the results of the observational study in Helena, MT are provocative: hospital admissions for acute myocardial infarction declined by about 40% during the six months in which a comprehensive local ordinance on clean air was in effect, and rebounded after the ordinance was suspended. . . .” “Even without future studies or replications of these findings, the data are sufficient to warrant caution regarding exposure to secondhand smoke.
    “Clinicians should be aware that such exposure can pose acute risks, and all patients at increased risk of coronary heart disease or with known coronary artery disease should be advised to avoid all indoor environments that permit smoking. Additionally, the families of such patients should be counseled not to smoke within the patient's home or in a vehicle with the patient. In addition to its impact on heart disease, exposure to secondhand smoke causes lung cancer in non-smokers, respiratory infections and asthma in children, and even death in exposed infants.” Once again ASH highlighted certain words from the article to emphasize that it was the CDC’s own conclusion that an “acute myocardial infarction” (i.e., a sudden and often fatal heart attack) can occur from the very brief exposure to drifting tobacco smoke one might encounter in a restaurant.

    D. After citing a number of other studies supporting the basic conclusion that exposure to secondhand tobacco smoke for even a brief period can be fatal, ASH noted an article in Circulation magazine entitled Cardiovascular Effects of Secondhand Smoke - Nearly as Large as Smoking.  It concluded that: “The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.” [emphasis added]

   E. In addition, for those who might still have any doubts, we now have the findings and conclusions of the California Air Resources Board.  This body, after exhaustive study and hearings, concluded that secondhand tobacco smoke, both indoors and outdoors, is a “TOXIC AIR CONTAMINANT” from which the public, by law, must be protected.  Here are some of its findings:

    i. Secondhand tobacco smoke causes (among other things) “lung cancer, nasal sinus cancer, and breast cancer in younger primarily premenopausal women”
    ii. Secondhand tobacco smoke also causes heart disease mortality [deaths], acute and chronic coronary heart disease morbidity, and altered vascular properties"
    iii In California alone, secondhand tobacco smoke each year causes “over 3,600 cardiac deaths” [this does not include deaths from cancers, etc.]
    iv. “Non-smokers are exposed to [secondhand tobacco smoke] in several different environments, such as outside office buildings . . .. The ARB monitored outdoor nicotine (a marker for ETS) concentrations in these environments and found that some of the highest nicotine monitoring results are comparable to those found in some smoker’s homes.”  [ASH has highlighted certain words in red for added emphasis.]

For more information, see:

http://ash.org/outdoors.pdf
http://www.arb.ca.gov/toxics/ets/factsheetets.pdf

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