DuPage County has some of the best statistics concerning smoking in Illinois and in the nation.
We have 82.2% of the population as nonsmokers.
This means almost one out of five of us smoke, this
is a very good rate, but unfortunately four out of five
will come in contact with secondhand smoke sometime somewhere.

What is secondhand smoke (SHS)? It is a mixture
of the smoke exhaled by a smoker and the smoke
that comes form the burning end of a cigarette, pipe
or cigar. Because cigarette smoking is the majority
of secondhand smoke I will refer to cigarettes throughout this talk, but all the information is the
same for pipes and cigars. Secondhand smoke is
also called passive or involuntary smoking and environmental tobacco smoke (ETS). Eighty five percent of this smoke lingers in the air for others to breathe and unfortunately contains over 4,000 chemicals of which at least 43 have been classified as carcinogens. Some of the chemicals found in SHS are tar: (used on streets and highways), carbon monoxide (car exhaust), formaldehyde (body preserving fluid), acetone (finger nail polish remover), methanol (rocket fuel), and Hydrogen cyanide (the poison used in the gas chamber). Not surprisingly tobacco smoke also contains nicotine and polycyclic aromatic hydrocarbons (part of the stink of cigarette smoke). The “9th report on Carcinogens” by the Environmental Health Information Service has declared secondhand smoke a class “A” carcinogen with no safe level of exposure. The two sources of SHS are side stream, which comes form the end of the burning cigarette, and mainstream smoke, which is the smoke, exhaled by the smoker. Side stream has higher concentration of some toxins and carcinogens because of the lower smoldering temperature. Although the air in the room dilutes SHS there is still particulates that are not removed by ventilation systems or air cleaners. A panel of ventilation experts from the Occupational Safety and Health Administration (OSHA) and the American Conference of Governmental Industrial Hygienists (ACGIH) concluded that ventilation would not control secondhand smoke. Even the American Society of Heating, Refrigeration and Air-Conditioning Engineers (ASHRAE) state in a policy statement to their board of directors “There is evidence that acceptable air quality cannot be achieve where smoking is permitted”. The extent of these particulates varies proportionally with the number of smokers, the intensity of their smoking and air exchange rate.

Why is this important? In December 2003 the California Environmental Agency stated “[The] Growing body of evidence…[indicates] that ETS exposure is causally associated with an increased risk for cardiovascular disease in the range of 20-50%…[and] may also contribute to stroke.” As evidence of this fact it was shown that in Helena Montana, after the enactment of a comprehensive clean indoor air ordinance there was a decrease in acute myocardial infarctions (heart attacks) by 60% in 6 months. Unfortunately Helena had its’ ordinance repealed and the rate of heart attacks reverted to the pre-ordinance level. In addition the 2004 Surgeon Generals report stated, “The evidence is sufficient to infer a causal relationship between active smoking and all major respiratory symptoms among children, adolescents and adults including coughing, phlegm, wheezing and dyspnea.”

So is secondhand smoke dangerous? Well it is the third leading contributor to those who die in the United States today An estimated 3,000 lung cancer deaths and 35,000 coronary heart disease deaths occur annually among adult nonsmokers in the United States as a result of exposure to secondhand smoke from the Center for Disease Prevention and Control’s (CDC) Morbidity and Mortality Weekly Report 2002;51(14):300–303. If a non-smoker spends just twenty minutes in a room with a smoker they will have inhaled the equivalent of one cigarette, after two hours the non-smoker is put at an elevated risk of a heart attack according to a 2001 article by Dr. Stanton Glantz in the Journal of the American Medical Association.

Children are the ones most affected by SHS. Acute respiratory illnesses happen twice as often to children whose parents smoke around them. If you smoke around your children they can inhale the equivalent of 105 packs of cigarettes by age 5. Each year, 280 children die from respiratory illness caused by SHS according to Campaign for Tobacco-Free Kids. Another 300 suffer injuries caused by smoking related fires (John Hopkins Bloomberg School of Public Health’s Institute for Global Tobacco Control Environmental Tobacco Smoke 2004).

Asthmatic children are especially at risk; exposure to SHS is a major trigger for asthmatic attacks. The EPA estimates that 200,000 to 1,000,000 asthmatic children have their conditions made worse by exposure to SHS. They also estimate that SHS exposure will cause thousands of non-asthmatic children to develop asthma each year.

Passive smoking can lead to a buildup of fluid in the middle ear, the most common cause of hospitalization of children for an operation. For children under 18 months of age passive smoking is responsible for between 150,000 and 300,000 lower respiratory tract infections (pneumonia and bronchitis) with 7,500-15,000 hospitalizations each year. Ten studies have linked Sudden Infant Death Syndrome (SIDS) to exposure to SHS (John Hopkins Bloomberg School of Public Health’s Institute for Global Tobacco Control Environmental Tobacco Smoke 2004).

Children are not the only ones to suffer our pets also breathe SHS. According to the Lung Cancer Center – Providence Health System in Oregon, dogs are 3 times more likely to develop lung and nasal cancers in households that have a smoker. Cats that live with smokers are more than two times as likely to develop a cancer called feline lymphoma than those in non-smoking households. Not to mention the tobacco residue that collects on their fur, when they groom themselves they will swallow this residue. Some pets even eat cigarette butts left unattended.

Non-smokers have the right to breathe clean air. A smoke filled room can contain up to 6 times the pollution of a busy highway. Non-smoking sections do little to eliminate exposure as smoke doesn’t know to stay in its’ own area. Although patrons of the hospitality industry are assaulted by smoke, those who work there are in greater danger because of the length of time spent in an atmosphere of secondhand smoke. Levels of secondhand smoke in restaurants are about 160-200% higher than in smoking offices — and 150% higher than in a home with at least one smoker, secondhand smoke levels in bars are 390-610% higher than in offices that permit smoking — and 450% higher than in homes with a smoker. The epidemiologic evidence suggested that there might be a 50% increase in lung cancer risk among food-service workers that is in part attributable to tobacco smoke exposure in the workplace (Siegel M., University of California, Berkeley/University of California. JAMA. 1993 Jul 28; 270(4): 490-3). The restaurant industry employs 11.7 million people or 9% of the total workforce (National Restaurant Association, Restaurant Industry Forecast at a Glance 2003). The service industries workforce/laborers (blue collar workers) comprises 27.3% of the national workforce; this group is least likely to be protected from secondhand smoke compared to 30.1% of professional occupations (white collar workers). Usually those employed in the service industry are not able to find other jobs in which to earn a living. Women make up a large part of this labor force

For women the risk of secondhand smoke is huge. Your risk of death from heart attack is 91% higher for non-smoking women who are regularly exposed to secondhand smoke and 58% higher for women occasionally exposed (American Heart Association Journal 1997). Nonsmoking women who live with a spouse who smokes have a 30 percent greater risk of developing lung cancer (SH Jee, H Ohrr, IS Kim. Effects of Husband’s Smoking on the Incidence of Lung Cancer in Korean Women, International Journal of Epidemioloy. 1999; 28: p. 824-828). Pregnant women exposed to secondhand smoke have a greater risk of miscarriages, stillbirth, and lower birth weight. Smoking has been shown to alter the age of natural menopause, an approximate twofold increase of being menopausal earlier (Everson RB, Sandler DP, Wilcox AJ, Schreinemachers D, Shore DL, Weinberg C. Effect of passive exposure to smoking on age at natural menopause. Br Med J (Clin Res Ed) 1986;293:792-.)

So what can you do about secondhand smoke?
1. Avoid people who smoke.
If you have a friend or family member who smokes, ask them not to smoke around you or your children. Tell them that you have designated the house and car as no-smoking areas. You also should alert babysitters, handymen, or anyone else who may come into your home or car that smoking is not allowed. Because tobacco residue will be on clothes, carpets, bedding limit the amount of time that your infant is held by smokers or placed on these surfaces in a smoking household.

2. Avoid restaurants, bars, and stores that allow smoking.
If you walk into a restaurant, bar, or store and discover that it allows smoking turn around and walk back out. By walking away, you protect your family from the harmful toxins in secondhand smoke and send a powerful message to business owners that you will not accept being exposed to secondhand smoke.

3. Motivate change in your community or work place.
If your favorite restaurant, bar, or store allows smoking, consider talking to the owner and suggest that smoking be banned. Say that you would like to continue doing business there but that you will not accept being exposed to secondhand smoke.

Take an active role in the development of your company’s smoking policy. Encourage your company to offer a stop smoking program for those who want to quit. If you work with people who smoke, consider approaching them and asking them not to smoke around you. You may want to talk to your manager or company leader and suggest that they designate a smoking area away from nonsmokers.

Join an advocacy group, write letters to local/state governmental officials, and collect signatures for petitions.

As the public becomes more aware that smoking is not only a hazard to smokers but also to others, nonsmokers have become more outspoken and smokers find themselves a beleaguered group. Be aware that smokers have a right to smoke if they choose to do so, but as in all situations concerning rights, if that right infringes on the health and safety of others than it must be restricted and regulated for the betterment of the good of all. Examples are speed controls, gun controls, air pollution controls and a multitude of other health and safety issues that are regulated and controlled to protect the lives of Americans