National and international research has abundantly documented that secondhand smoke is a cause of cancer.  There are 60 carcinogens in cigarette smoke.  The particulates constituting the visible smoke, which is less than 5 percent of the total effluent from a burning cigarette, carry the bulk of the carcinogens.  If only one of these carcinogens occurs in a manufacturing  process unrelated to tobacco, the Occupational Safety and Health Administration (OSHA) requires the worker to wear protective clothing and face mask.  But no federal law specifically protects nonsmokers from the carcinogenic burden of secondhand smoke.

Particulate matter in outside air is regulated under the Environmental Protection Agency's (EPA) Clean Air Act.  The National Ambient Air Quality Annual Standard has been 50 micrograms (ug) per cubic meter (m3) for particles 10 micron in diameter (PM10), 1/7 the width of a human hair.  Air quality  progressively worsens as particle concentrations (ug/m3) rise, being designated "moderate" (50 to 150), "unhealthful" (150 to 350), "very unhealthful" (350 to 420), and finally "hazardous" (over 420).  But again, the federal law stops at the entrances to indoor airspaces, leaving it to local government to protect the public, who spend 90% of their time indoors.

Since occasional serious adverse health effects, including deaths, were observed at particle concentrations below the 50 ug/m3 PM10 standard, EPA recently issued a new ambient standard of 15 ug/m3 for fine particulates less than 2.5 micron in diameter (PM2.5) which penetrate deep into the lungs.  Tobacco smoke particles fall in this category, measuring less than one micron in diameter.

If we were to apply the enforceable outdoor standard to indoor air,  the standard would be  exceeded wherever smoking is allowed,  ranking especially bars high up in the "hazardous" category.  When Michael Siegel of the University of California at Berkeley reported in the Journal of the American Medical Association (270: 490-493, 1993) that particulate concentrations in bars may be as high as 1,300 ug/m3  (thus exceeding the 50 ug/m3 outdoor standard by 26 times and the new EPA outdoor standard of 15 ug/m3 by almost 90 times), he insisted that "food service workers must be afforded the same public health protection as other workers" and that "smoking should be prohibited in bars and restaurants."

Air quality tests in several Manhattan smoking bars revealed that the air was 50 times worse there than at the entrance to the Holland Tunnel.  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".  New York Mayor Bloomberg stressed that smokers must not hurt others with secondhand smoke, and lawmakers must not let them.  He also emphasized that bar and restaurant workers, above all, must be protected.

New York city, Pueblo and Fort Collins, Colorado, and Dona Ana County and Las Cruces, New Mexico, recently passed comprehensive smoking bans, while Dallas, Denver, and Chicago are all considering smokefree workplace legislation in the very near future. Although these are encouraging developments, this process requires lots of time and energy and is much too slow to protect the workers and the general public from the unjustifiable risk of exposure to secondhand smoke.

It is therefore imperative that a long overdue nationwide ban of smoking in shared airspaces be instituted through federal action.  CDC could play a decisive role by presenting a compelling case for the protection of public health to the government.  CDC's latest estimates of annual U.S. mortality from secondhand smoke exposure not only list 3,000 lung cancer deaths but also an alarming 62,000 deaths from cardiovascular disease (Business Week, April 29. 2001).

Workplaces across the nation should finally be made smokefree by OSHA.  The general duty clause of the Occupational Safety and Health Act of 1970  states in Section 5 (a): "Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees."  But OSHA, despite repeated lawsuits by Action on Smoking and Health (ASH),  has failed to protect employees from the harmful exposures to tobacco smoke.

The case made above focused only on the particulate fraction of tobacco smoke and the glaring discrepancy between EPA's strict ambient air regulation and the lack of regulation concerning the much higher particulate pollution caused by smoking in indoor environments.  In addition, there are also numerous poisons and carcinogens contained in the vapor phase of cigarette smoke that substantially contribute to the physical harm of secondhand smoke exposure.

After Some100 Million Deaths - What's Next?, Priorities 13(4), 2001
Can Children Stop Big Tobacco?, A School Project
Workplaces and Public Places Must be Made Smokefree
Protein, An Alternative Tobacco Crop