Feature Article

The latest report of the U.S. Surgeon General is the first to focus on secondhand smoke since the landmark 1986 Surgeon General's report. This updated report should help dispel the remaining myths about the dangers of secondhand smoke, and advocates can use it as a powerful tool in efforts to reduce secondhand smoke exposure. At a press conference releasing the report, Surgeon General Richard Carmona stated clearly and simply: "The debate is over. The science is clear. Secondhand smoke is not a mere annoyance but a serious health hazard."

The Surgeon General made several major findings regarding the dangers of secondhand smoke. These conclusions were based on an examination of the best scientific evidence available. First, with regard to children, the report concluded that evidence was sufficient to infer a causal relationship between 1) parental smoking and lower respiratory illnesses in infants and children, 2) parental smoking and middle ear disease in children, 3) parental smoking and coughing, phlegm, wheezing, breathlessness, and asthma among children of school age, 4) maternal smoking during pregnancy and persistent and adverse effects on lung function across childhood, and 5) exposure to secondhand smoke after birth and a lower level of lung function during childhood.

Next turning to adults, the report concluded that exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. Nonsmokers who are exposed to secondhand smoke at home or work increase their risk of developing heart disease by twenty-five to thirty percent, while increasing their risk of developing lung cancer by twenty to thirty percent.

Importantly, the report emphasized that there is no risk-free level of exposure to secondhand smoke. Even short exposures to secondhand smoke can cause blood platelets to become stickier, damage the lining of blood vessels, and potentially increase the risk of a heart attack.

In terms of policy, the report concluded that eliminating smoking in indoor workplaces is the only way to fully protect nonsmokers from exposure to secondhand smoke. Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposure of nonsmokers to secondhand smoke. In addition, the report analyzed available studies and found that smoke-free policies have not been shown to have an adverse economic impact on the hospitality industry.

Though the report noted a substantial decrease in the exposure of nonsmokers to secondhand smoke in the U.S., millions are still exposed to secondhand smoke in their homes and workplaces. Forty-three percent of U.S. nonsmokers have detectable levels of cotinine, a biomarker of secondhand smoke. There is still much work to be done to protect everyone, including children, from the dangers of secondhand smoke exposure.

For the Surgeon General's report, click here.