SECONDHAND SMOKE -- HARMS & KILLS

Overview

Secondhand smoke has been officially declared a toxic pollutant.
Nations of the world, and states in the USA, going smoke-free
What is secondhand smoke?
Ventilation does not protect people from secondhand smoke.
Virginia -- current state law, 2008 legislative efforts
Restaurants -- Taste the food, or the smoke?
Separate sections do not work -- smoke travels, and does not read signs.
Secondhand smoking is the third leading preventable cause of death.

2008 -- Overview of recent items, see also Newest Entries.
"How Many Deaths Will it Take Before All Indoor Workplaces are NO-SMOKING?"

Fewer acute coronary events (strokes, heart attacks) following establishment of smoking ban.

Some conclusions from:
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, U.S. Department of Health and Human Services June 2006

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A landmark experiment in healthy young nonsmokers revealed that a mere 30 minute  exposure to secondhand smoke causes changes in coronary blood flow, specifically a substantial reduction in the coronary flow velocity reserve, that are indistinguishable from those of habitual smokers.

An April 7, 2006 study, British Medical Journal, revealed that secondhand smoke increases the risk of developing glucose intolerance or diabetes.

Dana Reeve, a non-smoker exposed to secondhand smoke in the nightclubs and other public places where she sang, died recently of lung cancer.  Secondhand smoke may well have been a factor in claiming her life.  All workplaces should be no-smoking to protect lives.

Heather Crowe, a former waitress in Canada, died in late May from lung cancer from the secondhand smoking on her job.  She has appeared in ads for the implementation of Smoke Free Ontario, and hoped to live to celebrate the May 31st beginning of that.  In her last commercial, she said, "people shouldn't go to work to die."  Her former employer appeared with her in some ads as support.

Additional information on smoking in the workplace under:
    Overview,  Secondhand smoke Kills,   Poisons,   Carcinogens,
    and also in the general information section.

Secondhand smoke Kills

Some Poisons in secondhand smoke

Immediate impacts of secondhand smoke
Impact on female fertility
Children -- Dental Decay caused by secondhand smoke
Further articles on women and tobacco at the INWAT,
    International Network of Women against Tobacco, web site.
Cost of secondhand smoke in dollars

Some articles and studies at National Library of Medicine

Secondhand smoke seeping into apartments and condominiums
New Jersey law prohibits smoking in college dormitories

Tobacco industry lost lawsuit challenging scientific report.
Tobacco companies do not show corporate responsibility.
Tobacco industry strategy to undermine research.
Tobacco industry strategy continues.
Tobacco industry used journal to report on secondhand smoke.
Tobacco industry stopped medical use of secondhand smoke exposure diagnostic
    code on medical forms.

Some References;  many others identified with article when mentioned.

Pets and secondhand smoke:

January 2006 -- A unanimous decision by the California Air Resources Board listed secondhand smoke as a toxic air contaminant, January, 2006.  The most significant new finding is that young women exposed to secondhand smoke increase their risk of developing breast cancer between 68% and 120%.   Breast cancer kills about 40,000 women in the United States each year.

New findings in the Cal-EPA report, Part B, include:
Part A of the report contains the first ever outdoor monitoring of secondhand smoke exposure near designated smoking areas in California.

The report has gone through an extensive, four-year scientific review process, including public comment and independent peer review.

SECONDHAND SMOKE COSTS USA $10 billion a year
EXCERPTS from Reuters, August 17, 2005

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There may be many things that people will accept secondhand -- but smoke is NOT one of them.  Tobacco Smoke is so dangerous, it can even kill secondhand.  It is the third preventable cause of death, after smoking and alcohol use.

Tobacco companies do not allow smoking around tobacco seedlings -- because it kills them -- tobacco mosaic virus. Tomato plants are also susceptible to this. 

People, as well as plants, are also hurt and killed by secondhand smoke.  For this reason, more and more workplaces are going smoke-free.  This protects both the nonsmoker and the smoker from the devastating health effects of secondhand smoke.

Tobacco companies have worked to stop the spread of laws and regulations which protect the health of people from secondhand smoke.  One recently exposed example is the lobbying to prohibit the use of a medical diagnostic code regarding secondhand smoke exposure.

Smoking is hazardous -- to the smoker, and to those who are forced to breathe the smoke.  This smoke is called secondhand smoke (SHS), passive smoke, and environmental tobacco smoke (ETS). 

Secondhand smoke has immediate impacts on health, and it can kill through triggering severe asthma attacks, heart attacks, several cancers, and other illnesses.  Women who have a smoking spouse have a significantly reduced chance of success with fertility treatments.

Secondhand smoke impacts the brain and can disorient the breather, lowering test scores, affecting reasoning and hand--eye relationships.  There is no safe level of exposure to secondhand smoke.

Secondhand smoke around the mother is as harmful to the developing fetus as is maternal smoking.

A study from Shanghai, China, noted an increase in stroke among nonsmoking women whose husbands smoked around them.  Prevalence of stroke also increased with increasing duration of husbands' smoking.  The authors found that women nonsmokers who lived with husbands who smoked had an elevated prevalence of stroke, and prevalence increased with increasing intensity and duration of husbands' smoking. 
The full text, February 2005, is available at the American Journal of Epidemiology.  Excerpts from a news article on this study is given later on this page.

A most informative governmental report from Ireland in 2002 on secondhand smoke in the workplace, based on worldwide research, concluded that the weight of evidence for lung cancer, cardiovascular, and respiratory disease, and for adverse effects on reproduction calls for legislative measures to protect employees from exposure to secondhand smoke at work.

A research team at Health Canada found that working in bars and restaurants can triple lung cancer risk.  They also observed a dose-response relation between the degree of exposure and lung cancer risk.

In the city of Helena, Montana (USA), the number of heart attacks decreased substantially after the city banned indoor smoking, but then rose quickly to its former level after the law was struck down in court six months later.  This event prompted the US Centers of Disease Control and Prevention (CDC) for the first time to warn people at risk of heart disease to avoid all buildings and gathering places that allow indoor smoking.

In Western New York State (USA) air pollution of RSPs (PM2.5) in a sample consisting of seven bars, six bar/restaurants, five restaurants, two bowling alleys, a pool hall, and a bingo hall dropped by 84% after implementation of the Clean Indoor Air Law in 2003.

In New York City (USA), "The city's bar and restaurant industry is thriving and its workers are breathing cleaner, safer air," said a report issued by the Economic Development Corporation and the Departments of Finance, Health & Mental Hygiene and Small Business Services.  Mike O'Neal, who served as president of the N.Y. State Restaurant Association for 17 years, supported legislation for a comprehensive smoking ban.  "I feel strongly," he said, "that it is pro-business and pro-health to eliminate smoking in all workplaces.  We owe our workers a safe, healthy work environment."

In the state of California (USA), the strict smoking bans have led to a substantial decline in smoking prevalence and also in the state's rates of heart disease, lung cancer, and chronic obstructive pulmonary disease (COPD), which have fallen well below the national average.

In New Zealand, the ban on smoking in the workplace, including pubs, has led to a  significant decrease in dangerous levels of gases linked to secondhand smoke related deaths.   In Excerpts from The New Zealand Herald, December 22, 2004, writer Helen Tunnah noted:

In Taiwan, a report on smoking in the workplace in Taiwan, Tobacco Control 2005:  14: i 33-i 37, noted that: 

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EXCERPTS from The Ottawa Citizen, April 9, 2006, headlined, Crowe wants to experience smoke-free future, writer Ron Corbett.

Looking frail, tired and at times disoriented, Heather Crowe said at a news conference yesterday she hopes to "be around to see" Smoke-Free Ontario legislation come into effect on May 31.

The former Ottawa waitress, who has never smoked, was diagnosed with lung cancer four years ago and is now in palliative care at the Elisabeth Bruyere Health Centre. Her condition was attributed to second-hand smoke in the restaurants where she worked for 40 years.

After being featured in many media reports, Ms. Crowe became a spokeswoman for various health agencies and went on to be featured in a high-profile television campaign about the perils of second-hand smoke.

This weekend's news conference -- held in the cafeteria of the health centre -- was to unveil another commercial in that campaign. This one features Ms. Crowe and Moe Atallah, owner of the Newport Restaurant, where Ms. Crowe worked for many years.

"Back then, we had no idea what we were doing with second-hand smoke," says Mr. Atallah. "We served ashtrays with the ketchup and the coffee. Everyone did that. I look back and just shake my head."

In the commercial, Mr. Atallah is seen near tears, while calling his former employee "my hero."

Ms. Crowe -- who looks healthier in the commercial, shot just weeks ago, than she does today -- says "people shouldn't go to work to die."

The commercials will air across Ontario over the next two months, in the runup to May 31 -- the implementation of Smoke-Free Ontario. On that date, smoking in public places will be banned across the province, with few exceptions.

"I'm in the last stages of this disease," she says. "It's going to be a grand day for me (when the legislation comes into effect). I hope to celebrate that day. I hope I'm around to have a cup of coffee."

In the rear of the room during the news conference, Ms. Crowe's daughter waited to bring her mother back to her room.  She says her mother has good days and bad days, and this was not one of the better days.

"Her memory is starting to go, and she's tired today," said Patricia Crowe.

"She takes cups full of pills just to kill the pain. It's just about constant now. The pain. But she wouldn't have missed this for the world."

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GASPer NOTE:  Dana Reeve was a nightclub singer, exposed on a daily basis to much secondhand smoke.  Many people do not remember the quantities of smoke in the air in earlier years.  We still have a long way to go to make it safe to breathe!

Excerpts from Larry King Live, CNN, March 7, 2006:

Joining us from Cleveland is Dr. Derek Raghaven, the Director of the Cleveland Cancer Center.  How did she have lung cancer without smoking?

Dr. Raghaven:  Well, I think, unfortunately, Larry, I believe she was a passive smoker.  You might remember that  Dana Reeve was a singer early in her life.  And my understanding  is that  she sang in places where smoking happened a lot.

One  of the things that isn't very well known is that, in many ways, passive smoking is much more dangerous than regular smoking, in the sense that, when you inhale a cigarette, it's hot and uncomfortable, and makes you cough.  When you're breathing in passive smoke, there isn't the same acute reaction.  And so you, in fact, inhale more deeply.  So she was exposed to passive smoking, as happens in so many parts of the USA.  We just haven't got legislation that's state-of-the-art to protect us.

Excerpts from nbc11.com, March 7, 2006, headlined:  Reeve's Death Sheds New Light On Lung Cancer, reporter not named.

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Alberta, British Columbia, Manitoba, New Brunswick, North West Territories, Nova Scotia, Nunavut, Ontario; Quebec considering this.

The University of Guam is smoke-free and tobacco-free as of August 1, 2006.

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There is no safe level of exposure to tobacco smoke.

The simple separation of smokers and nonsmokers within the same air space is not sufficient to protect nonsmokers.

Smoke cannot read signs, and it does not stay in the "smoking" section.

The US Environmental Protection Agency has concluded that "Research indicates that total removal of tobacco smoke through ventilation is both technically and economically impractical."

Ventilation is not the answer to protecting people from secondhand smoke.

The British Medical Association has declared that:

Particulate matter and toxic gases of secondhand smoke remain suspended in the air of a room, a car, and/or attached to walls, furnishings, and materials in the room, long after smoking has ceased.  This can trigger health problems for people who enter that room, car, etc.

Breathing secondhand-smoke causes morbidity and mortality from cancer, heart disease, and respiratory disease, as well as acute sensory irritation.  It causes the premature death of hundreds of thousands of nonsmokers worldwide.  Smoke-free buildings are the only remedy.  Secondhand smoke cannot be controlled by ventilation, air cleaning, or spatial separation of smokers from nonsmokers.

Normally, people are not sufficiently aware of their breathing, a largely automatic process, to pay attention to what they breathe or how much they breathe. 

For an adult male, for example,

Neither are people cognizant of the fact that the surface area of the lungs, consisting of millions of tiny air sacs (alveoli) open to the environment, is as large as a tennis court. This large surface area, constituting the interface between the inhaled air and a rich network of fine blood vessels surrounding the alveoli, guarantees an adequate uptake of oxygen to supply every cell in the body as well as the necessary removal of the toxic combustion product, carbon dioxide.

It is estimated that each year an estimated 2.25 million metric tons of gaseous and inhalable particulate matter of secondhand smoke are discharged into our personal air space.  

For example, emission estimates in the USA for the year 2002 for three of the major components of secondhand smoke in tons per year are as follows:

Smoking creates a toxic waste dump in the air that lingers long after the smoker has left the room, automobile, etc.

A low-tar filter cigarette may increase health hazards for nonsmokers exposed to its smoke, as more mutagens may be released through the burning end rather than through the filter tip.

The following are among the powerful poisons in secondhand smoke:

Among the carcinogens (cancer causing agents) in secondhand smoke are

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Secondhand smoke immediately impacts the respiratory system and can trigger asthma attacks which may be severe enough to cause death.  Secondhand smoke can also lead to pneumonia, bronchitis, and bronchiolitis.

Secondhand smoke can trigger migraine headaches, earaches, eye and throat irritation, and middle ear infections.

Secondhand smoke can trigger heart attacks and strokes.

An April 7, 2006 study, British Medical Journal, Thomas Houston et al., reveals that secondhand smoke increases the risk of developing glucose intolerance or diabetes.  The study followed 5,000 people -- blacks, whites, men, women -- aged 18-30 years, across the USA for 15 years, and found that glucose intolerance was developed by 22% of smokers, 17% of passive smokers, and 12% of people not exposed to smoke.

Secondhand smoke significantly reduces a woman's chance of success in fertility treatments.

Nicotine is changed into cotinine in the body.  In a study of 4,399 children aged 6 to 16, even the lowest exposure of secondhand smoke, as monitored by the levels of cotinine, a metabolite of nicotine, in blood, urine, saliva, and hair, was found to significantly impair, in a dose related manner, the children's reading, math, and reasoning scores.  In other words, in children and teenagers, even low amounts of secondhand smoke can significantly lower test scores by as much as 2-5 or more points and demonstrate a decline in the skills of reading, math, reasoning, and logic.  No safe level of exposure to secondhand smoke exists.  Quoting from that recent study, the authors stated:

Cancer
Cardiovascular Disease
Respiratory Disease
Perinatal death, miscarriage, low birth weight, Sudden Infant Death Syndrome (SIDS)

Cancer

Cardiovascular Diseases

A 2006 California Air Resources Board report found that secondhand smoke altered vascular properties, and labeled secondhand smoke a toxic air contaminant.

EXCERPTS from American Academy of Family Physicians, Journal, November 15, 2004, titled, Impact of Secondhand Smoke on Inflammation, author Karl Miller, M.D., reviewing:  Panagiotakos, DB, et al.  Effect of exposure to secondhand smoke on markers of inflammation: the ATTICA study.  American Journal of Medicine, February 1, 2004;116:145-50.

Next to active smoking and alcohol abuse, secondhand smoke is the third leading cause of poor health and premature death in the developing world. There are multiple mechanisms by which secondhand smoke has a negative effect on coronary risk factors. Inflammation markers have been shown to be related to the development of atherosclerotic disease. Panagiotakos and colleagues evaluated the effect of secondhand smoke on inflammatory markers related to cardiovascular disease in persons without any clinical evidence of cardiovascular or atherosclerotic disease.

When compared with persons who were not currently exposed to secondhand smoke, those with regular exposure had significantly higher white blood cell counts and C-reactive protein levels. In addition, the regularly exposed group had significantly higher homocysteine, fibrinogen, and oxidized LDL cholesterol levels compared with those who had no exposure. After adjusting for age, sex, physical activity, body mass index, and food consumption, persons with regular exposure to secondhand smoke had significantly higher levels of all of the inflammatory markers.

The authors conclude that exposure to secondhand smoke leads to inflammation and oxidation. This finding suggests that the impact of secondhand smoke on inflammation may be another pathophysiologic mechanism for the development of atherosclerosis. They add that more effort should be made to reduce involuntary exposure to secondhand smoke.

Coronary Heart Disease (CHD) is causally associated with secondhand smoke exposure. 
The latest estimate of the annual death toll from secondhand smoke-related CHD in the USA ranges from 22,700 to 69,600.  Underlying conditions such as diabetes, hypertension, or vascular disease worsen the risk.

Stroke -- Secondhand smoke can contribute to stroke due to atherosclerosis of the carotid artery and the large arteries of the brain as well as the degeneration of intracerebral arteries.

A recent study from Shanghai, China, noted an increase in stroke among nonsmoking women whose husbands smoked around them.  Prevalence of stroke also increased with increasing duration of husbands' smoking.  The authors found that women nonsmokers who lived with husbands who smoked had an elevated prevalence of stroke, and prevalence increased with increasing intensity and duration of husbands' smoking.  The full text is available at the American Journal of Epidemiology.

The mechanisms by which secondhand smoke affects the heart and blood vessels comprise

Secondhand smoke induced endothelial dysfunction, that is, a functional impairment of the linings of blood vessels, may finally explain why secondhand smoke can cause much greater damage to the cardiovascular system than one would have expected simply by comparing the quantities of cigarette smoke to which active and passive smokers are exposed. 

A recent landmark experiment (JAMA 2001) in healthy young nonsmokers revealed that a mere 30 minute exposure to secondhand smoke causes changes in coronary blood flow, specifically a substantial reduction in the coronary flow velocity reserve, that are indistinguishable from those of habitual smokers.  These changes are caused by nicotine which inhibits the self-regulatory widening of the coronary blood vessels (vasodilatation) in response to nitric oxide, an endogenous agent released by endothelial cells.  Since this effect of nicotine reaches its maximum already in the small amounts present in secondhand smoke, the difference between passive and active smoking as to their effects on blood vessels is greatly narrowed.  By the same token, smoking of only 1 to 3 cigarettes per day can cause heart disease by this mechanism.

Other factors contributing to heart disease and stroke are the adverse effect of secondhand smoke on blood lipids:  increase in "bad" cholesterol, LDL, decrease in "good" cholesterol, HDL, as well as platelet activation and elevated fibrinogen levels, all of which are associated with endothelial damage and plaque formation leading to atherosclerosis that, in turn, predisposes to coronary heart disease and stroke.

Respiratory Disease

The fetus and secondhand smoke -- Children and secondhand smoke

A 2006 report from the California Air Resources Board notes a causal link between secondhand smoke exposure and pre-term delivery.

Secondhand smoke can damage a developing fetus, and it can be as dangerous as primary exposure from maternal smoking.  This is reported in a 2005 study from the University of Pittsburgh Graduate School of Public Health and published in the online journal BMC Pediatrics.  Stephen G. Grant, Ph.D. reports that both active maternal smoking and secondary maternal exposure result in similarly increased rates of genetic mutation that are basically indistinguishable.

"This analysis shows not only that smoking during pregnancy causes genetic damage in the developing fetus that can be detected at birth, but also that passive -- or secondary -- exposure causes just as much damage as active smoking, and it is the same kind of damage. ... These kinds of mutations are likely to have lifelong repercussions for the exposed fetus, affecting survival, birth weight and susceptibility to disease, including cancer."

Secondhand smoke from either parent hurts the fetus.  The fetus is hurt by smoke from the pregnant mother who smokes, and the secondhand smoke breathed by the mother.

Secondhand smoke from either parent hurts infants and children.

Pregnant women who smoke, or who are around secondhand smoke, may find serious consequences for the fetus and later for the infant, such as:

This damage can be manifested in impaired lung development, decreased lung function, sudden infant death syndrome (SIDS), acute and chronic respiratory illnesses (including otitis media), and the induction and exacerbation of asthma.

Secondhand smoke exposure in pregnancy is responsible for a reduction in birth weight which is associated with respiratory problems and perinatal mortality.

The danger of SIDS, the most common cause of death in the first year of life, greatly increases for infants whose parents smoke near them.

Nicotine, which impacts the brain during critical stages of its intrauterine development in experimental animals, is a likely cause for the deficits in learning and memory, and the emotional and behavioral problems seen in childhood and later in life.

Prenatal nicotine also primes the adolescent brain for addiction.

Carcinogens reaching the fetus via the placental circulation can cause cancer later in life.

Experimental findings in mice suggest that prenatal secondhand smoke exposure may also promote development of adult cardiovascular disease.

Secondhand smoke increases the incidence of middle ear effusion in children.

Heart disease risks go up as secondhand smoke lowers kids' "good" cholesterol [HDL] and increases the "bad" cholesterol [LDL].

Children suffer great physical and psychological distress from secondhand smoke exposure.

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Association of Pediatric Dental Caries With Passive Smoking
Conclusions:  There is an association between secondhand smoke and risk of caries among children. Reduction of passive smoking is important not only for the prevention of many medical problems, but also for the promotion of children's dental health.

JAMA, Journal of the American Medical Association.  2003;289:1258-1264
Vol. 289 No. 10, March 12, 2003; C. Andrew Aligne, MD, MPH; Mark E. Moss, DDS, PhD; Peggy Auinger, MS; Michael Weitzman, MD

"The politicians in Ireland, Norway, and New York have decided to put the health of their citizens first by banning smoking in enclosed public places.  Surely we have a right to ask the same from our Governments?"

Passive smoking kills more than 11,000 a year in the UK -- much higher than previously thought, a study shows. The British Medical Journal study also gives a figure for people dying from second-hand smoke in the workplace - 600 a year - for the first time.

Leading doctors said the findings proved a complete ban on smoking in public places was needed.

But smoking lobby group Forest said there was still little hard evidence of the effect of passive smoking.

November's Public Health White Paper proposed a ban on smoking in public places with the exception of pubs which do not serve food.

At the time much of the medical establishment criticised the proposals for not going far enough.

But doctors have thrown their support behind Liverpool's bid to introduce a complete ban in all workplaces, which is due before the House of Lords later this month.

Researchers at University of Queensland in Australia compiled the report from UK databases of causes of death, employment, structure of households and levels of active smoking and exposure to passive smoking.

They found 2,700 deaths among people aged 20 to 64 could be attributed to second-hand smoke and 8,000 in 65-year-olds and over.

A further 617 deaths were caused by workplace passive smoking, including 54 in the hospitality industry.

Report author Konrad Jamrozik said: "It is clear that adoption of smoke free policies in all workplaces in the UK might prevent several hundred premature deaths each year."

Previous studies have put the figure much lower. The British Medical Association estimated it was 1,000 a year three years ago but said the latest study was a much more comprehensive guide to the problem.

BMA chairman James Johnson said: "As doctors we see first-hand how second-hand smoke kills.

"I don't know how John Reid [the home secretary] can continue to serve the public half-measures on health. We need a total ban and we need it now."

And Royal College of Nursing president Sylvia Denton said a complete ban would "save lives".

In a stark BMA report, The Human Cost of Tobacco, published today (9 November 2004), doctors chronicle individual stories behind the statistics to show how second-hand smoke destroys lives and health.

Every year [in England] at least 1000 people die from the effects of passive smoking. The BMA believes the biggest single step governments can take to improve the health of the public is to take action at national level to stop smoking in enclosed workplaces.

In his foreword to the report, BMA Chairman, Mr. James Johnson, offers the Health Secretary, John Reid, the same advice as smokers get:

There is no doubt that giving up smoking can be extremely difficult – like any addiction kicking the habit is no easy task. When smokers decide to quit they are often advised to set a date, bin the fags and then just do it. Support from a doctor or health professional during this time can be invaluable. I am going to give the same advice to John Reid.

In the forthcoming White Paper for England, he should set a date for banning smoking in all enclosed public places, this will give the bars and restaurants time to bin their ash-trays and then these workplaces will just have to abide by the law. John Reid already has the support of the medical profession.

The report charts around 70 cases throughout the United Kingdom of doctors’ experiences of dealing with patients who have been exposed to second-hand smoke. For example:

Lung Cancer
“I have had three confirmed cases of inoperable primary lung cancer in life-long non-smokers in the last two years. The biopsies showed the type of lung cancer only seen in smokers, and all three worked in public places where they were heavily exposed to secondary cigarette smoke. All three died within weeks of diagnosis.”

Respiratory Disease
"I have recently seen a thirty-four year old landlady with severe bronchial irritation and a history of recurrent wheezy chest infections caused by her work environment in a smoky pub. She now needs regular inhaled drugs including steroids to control her symptoms. She herself has never smoked.”

Children
“I saw a young boy on a number of occasions suffering from severe asthma attacks. His mother said she could not think of anything that brought on the attack, but the young boy said 'I always get sick after seeing granddad'. Apparently his grandfather owns a small and usually smoke filled restaurant.”

Pregnancy
“In my current post in obstetrics I see numerous cases of low-birth weight babies and difficult pregnancies exacerbated by passive smoking."

The BMA has been calling for legislation to ban smoking in enclosed public places since 1986.

The International Agency for Research on Cancer (IARC) classified tobacco smoke as a human carcinogen -- a global recognition
The World Health Organization -- another global recognition
The Surgeon General's Report on the Health Consequences of Involuntary Smoking, United States Department of Health and Human Services (USDHHS), 1986
The National Academy of Sciences, USA
The National Cancer Institute, USA
The National Institute for Occupational Safety and Health (NIOSH), USA
The National Research Council of the National Academy of Sciences, Report on Environmental Tobacco Smoke, 1986, USA
U.S. Environmental Protection Agency, 1992 Report, endorsed and reprinted by the National Cancer Institute, USDHHS, as Smoking and Tobacco Control Monograph 4, 1993.
California EPA, 1997, endorsed and reprinted by the National Cancer Institute, USDHHS, as Smoking and Tobacco Control Monograph 10, 1999, USA
California EPA Update
The U.S. Public Health Service

Calling it the nation's toughest law on college smoking, acting Gov. Richard Codey signed legislation yesterday that prohibits smoking in dormitories at both public and private New Jersey colleges.

"Today we are creating a safer, healthier college campus," Codey said before signing the bill at Drew University's Madison campus.

Two states, Connecticut and Wisconsin, have banned dorm smoking at public colleges, said Karen Blumenfield of New Jersey GASP, an anti-smoking organization. But local and national anti- smoking organizations said no state had ever banned smoking in dorms at both public and private institutions.

Drew University was the site of a Feb. 14 dormitory fire attributed to discarded cigarette ash on the floor of a room. More than 140 students were evacuated. No one was injured.

Sen. Barbara Buono (D-Middlesex), one of the bill's sponsors, said that incident gave the measure added momentum in the Legislature.

Enforcement of the ban will be primarily the responsibility of the colleges and universities, Codey said yesterday. But the law also allows individuals to bring complaints to the state or local board of health, which can impose fines of up to $200 for repeated violations.

More important, Willmore said, the law establishes a new social norm for students.

"This is establishing an environment in college campuses that discourages students from starting to smoke and encourages those who smoke to start to quit," he said. "It's an important legal step and an important cultural step, as well."

Some New Jersey schools, including Princeton, Seton Hall and Fairleigh Dickinson universities and Ramapo College, have already adopted their own dorm smoking bans, according to New Jersey GASP.

Drew University adopted a smoke-free dorm policy earlier this summer and sent letters to all its students. Spokesman Thomas Harris said yesterday the school is still working out enforcement, but he thought much of it would be educational or informational at first, and could ultimately result in fines for the smoker.

Several Drew students on campus yesterday endorsed both the school policy and the state law. Stephani Kim, 19, said she felt the ban would make her living conditions safer.

"You're living in a hall with up to 40 students," she said. "If there are people who don't want (to be around smoking), you're being disrespectful to them. ... I think smoking outside is more acceptable."

Stacy Serra, 20, started smoking at 17 but said she favors the ban and does not believe smoking in a dorm room is a privacy issue. "If they don't let you light candles in rooms, why should they let you smoke?"

Instead, as greedy drug pushers, they continue to promote their products and refuse to accept responsibility for their actions, blaming the user, not the manufacturer, blaming the addict, not the ones who made the product addictive. 

They post so-called information on their web sites stating that the products they make have been deemed by others to be harmful.  Since they continue to manufacture and advertise their products, this is apparently a legal ploy to try to say that they have sufficiently warned every consumer, so that no one can then sue them for any illness or death resulting from the use of their products.  This is immoral, obscene, and shows a total lack of compassion for both their consumers -- the smokers -- and those bystanders, including children and adults, who are forced to breathe the tobacco smoke.

This is not an industry that exhibits corporate responsibility.

Furthermore, as evidenced by the items given below on this page, they have in the past and continue to this day to try to intimidate scientists and to discredit peer reviewed studies.

IARC Press Releases http://www.iarc.fr, 2005

Tobacco industry undermining the basis of trust in Science

Bitton and colleagues publish in the current issue of Lancet further revelations about Tobacco Industry subterfuge employed to discredit scientific research, including work conducted at the International Agency for Research on Cancer (IARC), and to target specific scientists.

"The use of consultants, who fail to declare their associations with the tobacco industry, to publish purchased critiques of scientific research appears to remain one of the key strategic approaches of the Tobacco Industry" said Dr Peter Boyle, Director of the IARC. "Strategically coordinated attacks by hired guns, hiding behind undisclosed paid associations with industry, on the personal research of independent scientists by such means is at best unethical and at worst cowardly."

Mutations in p53 tumour suppressor gene have been reported in 60% of lung tumours. Work published from 1996 onwards, based to a large extent on IARC's p53 Database (http://www-p53.iarc.fr/index.html), demonstrated patterned mutagenic effect of benzo[a]pyrene, a carcinogen present in tobacco smoke. "The tobacco industry tried to tamper with this evidence because of the implications in the recognition of tobacco smoke as the cause of individual cases of lung cancer. Their strategy of infiltrating the scientific community to undermine the normal process of peer review and publication is distressing for the scientists whose work is targeted. It is also damaging for outstanding journals and academic institutions whose record with respect to tobacco research might appear to be blurred by the actions of a few individuals who maintained undisclosed tobacco industry ties."

"Such activity was supposed to be a thing of the past following the U.S. Master Settlement in the late 1990s, but obviously this is not the case" noted Dr Boyle. "The Tobacco companies claim that they are now working with the public health community to support a single, consistent public health message on the role played by cigarette smoking in the development of disease in smokers."

"If the Tobacco Industry is genuine in their recently proclaimed desire to work with the Public Health community then they cannot expect any cooperation if they continue to be involved in this and other similar activities. This Industry needs to demonstrate true corporate social responsibility. Until then, the public health community can have no confidence in the actions of the Tobacco Industry, and academic institutions should refuse any involvement with them, no matter how loudly the industry claims that they will not interfere in the research."

Nicolas Gaudin, Ph.D.
Chief, IARC Communications Group
International Agency for Research on Cancer
World Health Organization
France

Excerpted from EurekAlert, November 1, 2001 http://www.eurekalert.org/pub_releases/2001-11/uoc--idr110101.php

Two editorials commenting on the significance of this work are also in the journal: http://www.ajph.org/cgi/content/abstract/91/11/1742

http://www.ajph.org/cgi/content/abstract/91/11/1745

In the late 1980s, the international tobacco industry assisted in the establishment of the International Society of the Built Environment, which published the journal Indoor and Built Environment. Using evidence from tobacco industry documents, we examine the industry associations of the Society's executive, the journal's editor and board, and the extent to which the journal publishes papers on environmental tobacco smoke that would be deemed favourable by the tobacco industry. The society's executive has been dominated by paid consultants to the tobacco industry: all six members in 1992 and seven of eight members in 2002 had financial associations through industry lawyers. 67% of the editorial board in 1992 and 66% in 2002 had histories of financial associations with the tobacco industry. 61% (40/66) of papers related to environmental tobacco smoke published in Indoor and Built Environment in the study period reached conclusions that could be judged to be industry-positive.  Of these, 90% (36/40) had at least one author with a history of association with the tobacco industry. The executive of the International Society of the Built Environment and the editorial board of Indoor and Built Environment are in large part consisted of people with histories of consultancies to the tobacco industry. On the basis of the evidence presented in this paper, there is a serious concern the tobacco industry may have been unduly influential on the content of the journal.