Secondhand smoke harm pervasive

WASHINGTON -- Secondhand smoke dramatically increases the risk of heart disease and lung cancer in nonsmokers and can only be controlled by making indoor spaces smoke-free, according to a comprehensive report issued yesterday by US Surgeon General Richard Carmona.

``The health effects of secondhand smoke exposure are more pervasive than we previously thought," Carmona said. ``The scientific evidence is now indisputable: Secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults."

According to the report, the government's most detailed statement ever on secondhand smoke, exposure to smoke at home or work increases the nonsmokers' risk of developing heart disease by 25 percent to 30 percent and lung cancer by 20 percent to 30 percent. It is especially dangerous for children living with smokers and is known to cause sudden infant death syndrome, respiratory problems, ear infections, and asthma attacks in infants and children.

The report -- which was applauded and embraced by public health and tobacco-control advocates -- found that nearly half of all nonsmoking Americans are still regularly exposed to smoke from others. It concludes that any exposure to secondhand smoke is a risk to nonsmokers, and as a result the only way to protect nonsmokers is to eliminate indoor smoking.

``Restrictions on smoking can control exposures effectively, but technical approaches involving air cleaning or a greater exchange of indoor with outdoor air cannot," the report says.

``Consequently, nonsmokers need protection through the restriction of smoking in public places and workplaces and by a voluntary adherence to policies at home," particularly to eliminate exposures of children.

The report represents the strongest statement about smoking and tobacco control to emerge during the Bush administration -- which received millions in campaign donations from the tobacco industry. The administration has been neutral or negative about two major tobacco-control initiatives -- proposals to grant the Food and Drug Administration authority to regulate tobacco and enacting the World Health Organization global treaty on tobacco. The WHO treaty, for instance, was signed by the administration but has never been sent to the Senate for a ratification vote.

The tobacco industry has been somewhat divided on the dangers of secondhand smoke, with R.J. Reynolds Tobacco Co. saying that the science remains inconclusive and Philip Morris USA generally willing to accept public health advocates' conclusions.

A Philip Morris spokeswoman said yesterday that the company was reviewing the report, while R.J. Reynolds spokesman David Howard said that the report ``does not change our views about secondhand smoke." He said that the company continued to believe that owners of bars, nightclubs, and other places restricted to adults should decide whether to allow smoking.

On its website yesterday, the company said ``there are still legitimate scientific questions concerning the reported risks of secondhand smoke."

The report does not present new scientific data, but rather is an analysis of the best research on secondhand smoke. It said, for instance, that the Centers for Disease Control and Prevention estimated last year that exposure to secondhand smoke kills more than 3,000 nonsmokers from lung cancer, approximately 46,000 from coronary heart disease, and as many as 430 newborns from sudden infant death syndrome.

Ron Davis, president-elect of the American Medical Association, added, ``This report should be a wake-up call for lawmakers to enact comprehensive clean indoor air laws that prohibit smoking in all indoor public places and workplaces."

The surgeon general directly accused the tobacco industry of trying to minimize the scientific consensus on the dangers of environmental tobacco smoke.

``The industry has funded or carried out research that has been judged to be biased, supported scientists to generate letters to editors that criticized research publications, attempted to undermine the findings of key studies, assisted in establishing a scientific society with a journal, and attempted to sustain controversy even as the scientific community reached consensus," the report said.

There are more than 50 cancer-causing chemicals in secondhand smoke, and smokers and nonsmokers in rooms with smokers inhale many of the same toxins. Because the bodies of infants and children are still developing, the report says, they are at special risk for secondhand smoke. Even short exposure to secondhand smoke can lead to immediate cardiovascular problems, long-term health problems, and lung disease, the report concludes.

The surgeon general last addressed secondhand smoke in 1986. The Environmental Protection Agency and the California EPA have both addressed the issue since then -- concluding that nonsmokers are at risk for secondhand smoke -- but the surgeon general is generally considered the nation's most authoritative source on issues of science and tobacco.