ENVIRONMENTAL TOBACCO SMOKE

(ETS)

As the population of nonsmokers rises, so does the demand for the right to breathe clean air. Although fewer than 30 percent of Americans are smokers, air pollution from smoking in public places continues to be a problem. medrx-one.com

Environmental tobacco smoke (ETS) is divided into two categories: mainstream smoke and sidestream smoke (also called secondhand smoke). Mainstream smoke refers to smoke drawn through tobacco while inhaling; sidestream smoke refers to smoke from the burning end of a cigarette or to smoke exhaled by a smoker. People who breathe smoke from someone else's smoking product are said to be involuntary or passive smokers. Nearly 9 out of 10 nonsmoking Americans are exposed to environmental tobacco smoke. In fact, measurable levels of nicotine were found in the blood of 88 percent of all nontobacco users. This documents the widespread exposure of people in the United States to ETS.

Risks from ETS

Although involuntary smokers breathe less tobacco active smokers do, they still face risks from exposure tobacco smoke. Sidestream smoke actually contains more carcinogenic substances than the smoke that a smoker inhales. According to the American Lung Association, sidestream smoke has about 2 times more tar and nicotine, 5 times more carbon monoxide, and 50 times more ammonia than mainstream smoke. ETS is estimated to be responsible for approximately 3,000 lung cancer deaths, 37,000 cardiovascular disease deaths, and 13,000 deaths from other cancers. The Environmental Protection Agency (EPA) has designated second-hand tobacco smoke a group A cancer-causing agent that is even worse than other group A threats such as benzene, arsenic, and radon. The EPA has no power to regulate levels of indoor tobacco smoke, but officials believe that the agency's recommendations carry weight with employers and local governments. There is also evidence that sidestream smoke poses an even greater risk for death due to heart disease than for death due to lung cancer.

Sidestream smoke is estimated to cause more death per year than any other environmental pollutant. The risk of dying because of exposure to passive smoking is 100 times greater than the risk that requires the EPA to label a pollutant as carcinogenic and 10,000 times greater than the risk that requires the labeling of a food as carcinogenic.

Lung cancer and heart disease are not the only risks involuntary smokers face. Exposure to ETS among child increases their risk of suffering from lower respiratory tract infections. An estimated 300,000 children are at greater risk of pneumonia and bronchitis as a result of their exposure to ETS. Children exposed to sidestream smoke have a greater chance of developing other respiratory problems, such as cough, wheezing, asthma, and chest colds, along with a decrease in pulmonary performance. The greatest effects of sidestream smoke are seen in children under the age of 5. Children exposed to sidestream smoke daily in the home miss 33 percent more school days and have 10 percent more colds and acute respiratory infections than those not exposed. A recent study found that 31.2 percent of children are exposed to cigarette smoke daily in the home. This study found wide regional, income, and education differences: children of high-income, high-education-level parents in California are exposed far less than are children of low-income, low education-level parents in the Midwest.

Cigarette, cigar, and pipe smoke in enclosed areas presents other hazards to nonsmokers. An estimated 10 to 15 percent of nonsmokers are extremely sensitive (hypersensitive) to cigarette smoke. These people experience itchy eyes, difficulty in breathing, painful headaches, nausea, and dizziness in response to minute amounts of smoke. The level of carbon monoxide in cigarette smoke contained in enclosed places is 4,000 times higher than the clean air standard recommended by the EPA.

Efforts to reduce the hazards associated with passive smoking have been gaining momentum in recent years. Groups such as GASP (Group Against Smokers' Pollution) and ASH (Action on Smoking and Health) have been working since the early 1970s to reduce smoking in public places. In response to their efforts, some 44 states have enacted laws limiting or restricting smoking in public places such as restaurants, theaters, bowling alleys, public schools, airports, and bus depots. The federal government has restricted smoking in all government buildings. Hotels and motels now set aside rooms for nonsmokers, and car rental agencies designate certain vehicles for nonsmokers. Since 1990, smoking has been banned on all domestic airline flights. During 1994, McDonald's banned smoking in 1,400 of its company-owned fast-food restaurants and 20 major-league baseball parks went smokeless.

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