The Health Consequences of Involuntary
Exposure to Tobacco Smoke:
A Report of the Surgeon General, U.S.
Department of Health and Human Services
6 Major Conclusions of the Surgeon
General Report
Smoking is the single greatest avoidable cause of disease
and death. In this report, The
Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the
Surgeon General,
the Surgeon General has concluded that:
1. Many millions of Americans, both children and adults, are still exposed
to secondhand smoke in their homes and workplaces despite substantial progress
in tobacco control.
Supporting Evidence:
- Levels of a chemical called cotinine, a biomarker
of secondhand smoke exposure, fell by 70 percent from 1988-91 to 2001-02. In
national surveys, however, 43 percent of U.S. nonsmokers still have detectable
levels of cotinine.
- Almost 60 percent of U.S. children aged 3-11 years
or almost 22 million children are exposed to secondhand smoke.
- Approximately 30 percent of indoor workers in the
United States are not covered by smoke-free workplace policies.
2. Secondhand smoke exposure can cause disease and
premature death in children and adults who do not smoke.
Supporting Evidence:
- Secondhand smoke contains hundreds of chemicals
known to be toxic or carcinogenic (cancer-causing), including formaldehyde,
benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide.
- Secondhand smoke has been designated as a known
human carcinogen (cancer-causing agent) by the U.S. Environmental
Protection Agency, National Toxicology Program and the International Agency for
Research on Cancer (IARC). The National Institute for Occupational Safety and
Health has concluded that secondhand smoke is an occupational carcinogen.
3. Children exposed to secondhand smoke are at an
increased risk for sudden infant death syndrome (SIDS), acute respiratory
infections, ear problems, and more severe asthma. Smoking by parents causes
respiratory symptoms and slows lung growth in their children.
Supporting Evidence:
- Children who are exposed to secondhand smoke are
inhaling many of the same cancer-causing substances and poisons as smokers.
Because their bodies are developing, infants and young children are especially
vulnerable to the poisons in secondhand smoke.
- Both babies whose mothers smoke while pregnant and
babies who are exposed to secondhand smoke after birth are more likely to die
from sudden infant death syndrome (SIDS) than babies who are not exposed to
cigarette smoke.
- Babies whose mothers smoke while pregnant or who
are exposed to secondhand smoke after birth have weaker lungs than unexposed
babies, which increases the risk for many health problems.
- Among infants and children, secondhand smoke cause
bronchitis and pneumonia, and increases the risk of ear infections.
- Secondhand smoke exposure can cause children who
already have asthma to experience more frequent and severe attacks.
4. Exposure of adults to secondhand smoke has
immediate adverse effects on the cardiovascular system and causes coronary
heart disease and lung cancer.
Supporting Evidence:
- Concentrations of many cancer-causing and toxic
chemicals are higher in secondhand smoke than in the smoke inhaled by smokers.
- Breathing secondhand smoke for even a short time
can have immediate adverse effects on the cardiovascular system and interferes
with the normal functioning of the heart, blood, and vascular systems in ways
that increase the risk of a heart attack.
- Nonsmokers who are exposed to secondhand smoke at
home or at work increase their risk of developing heart disease by 25 - 30
percent.
- Nonsmokers who are exposed to secondhand smoke at
home or at work increase their risk of developing lung cancer by 20 - 30
percent.
5. The scientific evidence indicates that there is
no risk-free level of exposure to secondhand smoke.
Supporting Evidence:
- Short exposures to secondhand smoke can cause blood
platelets to become stickier, damage the lining of blood vessels, decrease
coronary flow velocity reserves, and reduce heart rate variability, potentially
increasing the risk of a heart attack.
- Secondhand smoke contains many chemicals that can
quickly irritate and damage the lining of the airways. Even brief exposure can
result in upper airway changes in healthy persons and can lead to more frequent
and more asthma attacks in children who already have asthma.
6. Eliminating smoking in indoor spaces fully
protects nonsmokers from exposure to secondhand smoke. Separating smokers from
nonsmokers, cleaning the air, and ventilating buildings cannot eliminate
exposures of nonsmokers to secondhand smoke.
Supporting Evidence:
- Conventional air cleaning systems can remove large
particles, but not the smaller particles or the gases found in secondhand
smoke.
- Routine operation of a heating, ventilating, and
air conditioning system can distribute secondhand smoke throughout a building.
- The American Society of Heating, Refrigerating and
Air-Conditioning Engineers (ASHRAE), the preeminent U.S. body on ventilation
issues, has concluded that ventilation technology cannot be relied on to
control health risks from secondhand smoke exposure.
The
Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the
Surgeon General was prepared by the Office on Smoking and Health, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention (CDC).
The Report was written by 22 national experts who were
selected as primary authors. The Report chapters were reviewed by 40 peer
reviewers, and the entire Report was reviewed by 30 independent scientists and
by lead scientists within the Centers for Disease Control and Prevention and
the Department of Health and Human Services. Throughout the review process, the
Report was revised to address reviewer's comments.
Citation
U.S. Department of
Health and Human Services. The
Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the
Surgeon General.
U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention, National Center for Chronic Disease Prevention and Health
Promotion, Office on Smoking and Health, 2006.
Last revised: June 27, 2006