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EXCERPTS FROM: Evidence points to health risks of secondhand smoke
As City Council considers a plan to limit smoking in restaurants and other public spots, research continues.
Experts cite years of studies.

By Mark Jaffe, Philadelphia Inquirer [05/25/00]  To read the article, click here:
Evidence points to health risks of secondhand smoke

                    Smoke," the lyrics of the old Jerome Kern song lament, "gets in your eyes."
                   But that's not the only place it ends up.

                   Research shows it also gets in your lungs and bloodstream - even if you don't
                   smoke yourself.

                   Secondhand tobacco smoke so permeates society that one federal study found
                   traces of nicotine in the blood of nine out of 10 nonsmokers among 10,000
                   people tested.

                   As Philadelphia City Council prepares to take testimony today on a proposed
                   ordinance to limit smoking in restaurants and other public places, the search to
                   precisely define the risk posed by this ubiquitous vapor goes on.

                   But the weight of the evidence over the last 14 years points to the growing
                   likelihood that environmental tobacco smoke contributes to cancer, heart disease
                   and respiratory ailments.

                   "There is lots of information now suggesting that secondhand smoke is a
                   significant public-health issue," said Mary Smith, director of the U.S.
                   Environmental Protection Agency's Indoor Environment Division.

                   The data come from about 40 epidemiological studies on secondhand smoke
                   and lung cancer and 20 studies on cardiovascular disease. "They have been
                   pretty consistent," said Jonathan Samet, a Johns Hopkins University School of
                   Public Health epidemiologist and an expert on secondhand smoke.

                   Nationally, the number of ordinances on public smoking has swelled six-fold
                   during the last 15 years. Today, 845 municipalities and 28 states have laws
                   limiting smoking in public places, according to the American Non-Smokers
                   Rights Foundation and the federal Centers for Disease Control and Prevention.

                   "Boston, New York, Los Angeles, San Francisco, San Diego all have controls
                   on smoking in public places," said Edward Sweda Jr., a senior attorney with the
                   Tobacco Control Resource Center at Northeastern University in Boston.
                   "Controlling smoking in public places has become an established municipal
                   activity."

                   Nevertheless, the CDC last week added environmental tobacco smoke to its list
                   of known carcinogens, although experts concede even that link is not conclusive.

                   "Part of the issue has been quantifying the risk of environmental tobacco smoke,"
                   Samet explained. "Is it a carcinogen? Yes. How much of a carcinogen? That is a
                   more complicated question."

                   So what precisely is known about secondhand smoke and the risks it poses?

                   The content of the fumes - a mixture of the smoke exhaled by the smoker and
                   smoke from the burning tobacco - has been analyzed, and it contains 4,000
                   chemicals, including 45 known or suspected carcinogens.

                   Present in tobacco smoke are cancer-linked substances such as benzene,
                   formaldehyde and benzopyrene. Other toxic agents include carbon monoxide,
                   acetone, acrolein and nicotine.

                   How much of these chemicals find their way into the lungs of a nonsmoker dining
                   in a restaurant or bending an elbow at a local pub is not clear.

                   One study, however, found that in a smoky bar a person could inhale as much as
                   98 parts per billion of benzene in an hour. There is no EPA ambient air standard
                   for benzene; the health standard for drinking water is 5 parts per billion.

                   That hour in a smoky bar can also give a nonsmoker the same dose of
                   nitrosamine - another carcinogen - as smoking 35 cigarettes, according to Health
                   Canada, that country's national health agency.

                   Perhaps the most dramatic study on the pervasiveness of secondhand smoke
                   was the CDC's Third National Health and Nutrition Examination Survey,
                   conducted between 1988 and 1991.

                   Analyzing blood samples from 10,000 participants, the CDC discovered
                   measurable levels of cotinine - a metabolized form of nicotine - in 88 percent of
                   the nonsmokers. Cotinine was a sign that the subject had been exposed to
                   tobacco smoke within the previous three days.

                   The weight of these studies led the EPA, in 1992, to classify environmental
                   tobacco smoke as a Class A, or "known human," carcinogen. The EPA
                   estimated that 3,000 lung cancer deaths a year in nonsmokers can be attributed
                   to secondhand smoke.

                   Several recent studies have calculated that environmental tobacco smoke may be
                   an even more serious threat for heart disease and could be responsible for as
                   many as 62,000 heart disease-related deaths a year - 20 times the number of
                   lung-cancer deaths.

                   A recent study by Health Canada also indicated that long-term exposure to
                   secondhand smoke might be linked to a significant increase in breast cancer.

                   Published in March in Cancer Cause and Control, the study evaluated 1,420
                   women and found that premenopausal women with long-term exposure to
                   secondhand smoke had a 100 percent greater chance of contracting breast
                   cancer. In postmenopausal women the risk was 30 percent greater.

                   The impact of environmental smoke on children is even clearer, with studies
                   showing decreased lung function, higher risk of respiratory infections, and
                   worsened asthma in up to a million American children each year.

                   For both children and adults, the research has consistently pointed in one
                   direction, experts contend."EPA's 1992 risk assessment created some
                   controversy," the agency's Smith said, "but the research over the last eight years,
                   I think, tends to bear out the agency. Environmental tobacco smoke is a key
                   public-health issue."