effects of second hand smoke



second hand smoke

second hand smoke

See also tobacco smoking and Health effects of tobacco smoking
"Second Hand Smoke" redirects here. For the Sublime album, see Second-hand Smoke (album)
This photo illustrates smoke in a pub, a common complaint from those concerned with passive smoking

Passive smoking (also known as involuntary smoking, secondhand smoking, or Environmental Tobacco Smoke) occurs when the smoke from one person's burning tobacco product (or the smoker's exhalation) is inhaled by others. There is controversy surrounding the health risks of long term exposure to second hand smoke, but the most recent studies confirm the health risks. In 1992, Passive smoke was classified as a Group A carcinogen, which means it is known to cause cancer in humans.[1] Passive smoking is one of the key issues leading to smoking bans in workplaces, smoke-free restaurants, and public places.

Contents

  • 1 Short-term effects
  • 2 Long-term effects
    • 2.1 Epidemiological studies of passive smoking
    • 2.2 Studies of passive smoking in animals
    • 2.3 Risk level of passive smoking
  • 3 Environmental Tobacco Smoke and Particulate Matter Emission
  • 4 Controversy
    • 4.1 Enstrom and Kabat
  • 5 Tobacco industry response
  • 6 Smoking bans
  • 7 Notes
  • 8 External links

Short-term effects

Some non-smokers are able to stay in a room with smokers for quite some time and notice little or no effects. For others, however, just a few minutes or an hour of exposure can make them feel quite ill. Persons with asthma can experience attacks brought on by smoking[2], and by passive smoking [3] whether they are adults or children([4], [5], [6], supporting calls for a smoking ban[7]).

Tobacco smoke is an allergen, and allergy sufferers can experience stuffy, runny noses, watery eyes, sneezing, coughing, wheezing, and all the other typical allergy symptoms within minutes of exposure. Some people with no known allergies and without asthma may cough in smoke-filled rooms, get headaches, feel nauseous, feel sleepy, and experience other ill effects. Many former smokers, and those who are trying to quit do not like to be around smoke as it can cause them to have cravings. Some people simply do not like the odor, which clings to hair and clothing.

Many of these short-term effects terminate after the exposure ends. Repeated exposure, however, is believed to cause more serious long-term effects.

Long-term effects

A wide array of negative effects are often attributed, in whole or in part, to frequent, long term exposure to second hand smoke. The extent to which the smoke influences the development of these negative effects is the subject of much debate and controversy. Some of the symptoms which have been or are frequently attributed to second hand smoke include:

  • Increased risk of lung cancer
    • The effect of passive smoking on lung cancer has been extensively studied. Studies from the USA (1986[8], [9], 1992[10], 1997[11], 2001[12], 2003 [13]), Europe (1998[14]), the UK (1998[15], [16]), and Australia (1997[17]) have consistently shown a significant increase in relative risk among those exposed to passive smoke.
  • Increased risk of cancer [18]
  • Increased risk of heart disease [19]
  • Increased risk of miscarriage and birth defects [20]
  • Increased risk of SIDS (Sudden Infant Death Syndrome) [21]
  • Increased risk of developing asthma, both for children[22] and adults[23] [24]
  • Learning difficulty in children
  • Increased risk of behavior problems in children, such as depression, anxiety and immaturity. (http://web.ebscohost.com.proxy-bc.researchport.umd.edu/ehost/detail?vid=23&hid=14&sid=77b4eba7-34a7-41c4-8a00-99cae6a629cf%40sessionmgr2)
  • Increased risk of lung infections
  • Increased risk of ear infections[25]
  • Increased risk of allergies in children[26]
  • Worsening of asthma, allergies, and other conditions[27]

Although the nature of passive smoking makes study design problematic, meta-analyses from around the world suggest that dangers of passive smoking are significant.[28] [29] [30]

Passive smoking kills about 53,000 nonsmokers per year, making it the 3rd leading cause of preventable death in the U.S.[31]

Epidemiological studies of passive smoking

Epidemiological studies suggest that non-smokers exposed to secondhand smoke are at risk for many of the health problems associated with direct smoking.

In 1992, the Journal of the American Medical Association published a review of the evidence available from epidemiological and other studies regarding the relationship between secondhand smoke and heart disease and estimated that passive smoking was responsible for 35,000 to 40,000 deaths per year in the United States in the early 1980s.[32] Some studies make the claim that non-smokers living with smokers have about a 25 per cent increase in risk of death from heart attack, are more likely to suffer a stroke, and can sometimes contract genital cancer. Some research, such as the Helena Study, suggests that risks to nonsmokers may be even greater than this estimate. The Helena Study claims that exposure to secondhand smoke increases the risk of heart disease among non-smokers by as much as 60 percent. [33] Parents who smoke appear to be a risk factor for children and babies and are associated with low birth weight babies, sudden infant death syndrome (SIDS), bronchitis and pneumonia, and middle ear infections.[34]

In 2002, a group of 29 experts from 12 countries convened by the Monographs Programme of the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) reviewed all significant published evidence related to tobacco smoking and cancer. It concluded:

These meta-analyses show that there is a statistically significant and consistent association between lung cancer risk in spouses of smokers and exposure to secondhand tobacco smoke from the spouse who smokes. The excess risk is of the order of 20% for women and 30% for men and remains after controlling for some potential sources of bias and confounding.[35]

Additionally, studies assessing passive smoking without looking at the partners of smokers have found that high overall exposure to passive smoking is associated with greater risks than partner smoking and is widespread in non-smokers[36].

The National Asthma Council of Australia[37] cites studies showing that: Environmental tobacco smoke (ETS) is probably the most important indoor pollutant, especially around young children:

  • Smoking by either parent, particularly by the mother, increases the risk of asthma in children.14,15,<LE III-2>
  • The outlook for early childhood asthma is less favourable in smoking households.15,<LE III-2>
  • Children with asthma who are exposed to smoking in the home generally have more severe disease.16,<LE III-1>
  • Many adults with asthma identify ETS as a trigger for their symptoms.17,<LE III-1>
  • Doctor-diagnosed asthma is more common among non-smoking adults exposed to ETS than those not exposed. Among people with asthma, higher ETS exposure is associated with a greater risk of severe attacks.18,<LE III-2>

In France passive smoking has been shown to cause between 3000[38] and 5000 premature deaths per year, with the larger figure cited by Prime minister Dominique de Villepin during his announcement of a nationwide smoking ban: "That makes more than 13 deaths a day. It is an unacceptable reality in our country in terms of public health."[39]

Studies of passive smoking in animals

Experimental studies in which animals are exposed to tobacco smoke have produced results supporting the view that exposure to secondhand or 'environmental' tobacco smoke is carcinogenic. The International Agency for Research on Cancer expert group concluded that:

There is limited evidence in experimental animals for the carcinogenicity of mixtures of mainstream and sidestream tobacco smoke.
There is sufficient evidence in experimental animals for the carcinogenicity of sidestream smoke condensates.[40]

A study conducted by the Tufts' School of Veterinary Medicine and the University of Massachusetts concluded that a cat living with a smoker is two times more likely to get feline lymphoma than one that is not. After five years living with a smoker, that rate increases to three times as likely. And, when there are two smokers in the home, the chances of getting feline lymphoma increases to four times as likely[41].

A study by Colorado State University found that a dog that has exposure to a smoker in the home is 1.6 times more likely to develop lung cancer than a dog that is not exposed to a smoker. The study also found that skull shape had an effect on the estimated risk of lung cancer in dogs.[42]

Risk level of passive smoking

The International Agency for Research on Cancer concluded in 2002 that:

There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) causes lung cancer in humans.
Involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) is carcinogenic to humans (Group 1).[43]

Most experts believe that moderate, occasional exposure to secondhand smoke presents a small, but measurable cancer risk to nonsmokers. The risk is considered more significant if non-smokers work in an environment where cigarette smoke is prevalent, although few studies bear this out.[44]

In May 2006, the United States government's Center for Disease Control issued its first new study on secondhand smoke in 20 years. Surgeon General Richard Carmona summarized, "The health effects of secondhand smoke exposure are more pervasive than we previously thought. 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." The study estimated that living or working in a place where smoking is permitted increases the non-smokers' risk of developing heart disease by 25-30% and lung cancer by 20-30%. The study finds that passive smoke also causes sudden infant death syndrome (SIDS), respiratory problems, ear infections and asthma attacks in children.[45]

Environmental Tobacco Smoke and Particulate Matter Emission

Environmental tobacco smoke (ETS) was shown to be a much higher source of pollution than an ecodiesel engine in regard to particulate matter (PM) emission. In fact three cigarettes smouldering in a room of 60 m3 with a limited air exchange, a setting commonly encountered in everyday life, were able to produce PM concentrations up to 10-fold that of the engine’s emissions, and up to 15-fold PM10 and PM2.5 outdoor limits, in agreement with previous data on ETS pollution observed in the hospitality industry.[46]

Controversy

Some controversy has attended efforts to estimate the specific risk of lung cancer related to passive smoking. In 1993, the US Environmental Protection Agency (EPA) issued a report[47] estimating that 3,000 lung cancer related deaths in the U.S. were caused by passive smoking every year. The Congressional Research Service issued a report that generally endorsed the findings of the study,while noting that 'a few researchers have challenged the classification of ETS as a known carcinogen'.[48] Among those testifying in favour of the tobacco industry at the inquiry was Congressman Thomas J Bliley, who had received more than $22,900 from tobacco companies in 1993-4[49], and more than $53,000 from them in 1995-1996[50].

Philip Morris, R.J. Reynolds and groups representing growers, distributors and marketers took legal action, claiming that the EPA manipulated scientific studies and ignored accepted scientific and statistical practices. In 1998 United States District Court Judge William Osteen, a former tobacco lobbyist[51], vacated this study, declaring it null and void in a 92-page decision, that found that the EPA had manipulated results and violated scientific norms in order to achieve its pre-determined conclusion that passive smoke was harmful. Even though Osteen had worked as a lobbyist for the tobacco industry prior to becoming a judge, he had delivered a ruling contrary to the interests of tobacco companies in 1997 he had refused to strike down a FDA rule restricting young people's access to tobacco products[51].

Osteen's decision was overturned by the United States Court of Appeals for the Fourth Circuit in 2002 on the technical grounds that the report was not a reviewable agency action under the Administrative Procedure Act, and the EPA classification of tobacco was ultimately left intact. Because the substantive dispute was never resolved, the findings in Osteen's report are still used to argue that the issue of ETS is driven by politics rather than science.[52][53]

Enstrom and Kabat

Two recent studies by Enstrom and Kabat[54][55] conclude that the previous studies overestimated the effect of Environmental Tobacco Smoke (ETS) on both lung cancer and heart diseases.

These studies have been criticised by the American Cancer Society, which describes the study as "misinformation", on the grounds that both the original cohort and Enstrom and Kabat's follow-ups, were inappropriate for reliably determining ETS exposure, smoking history, etc. Furthermore, Enstrom and Kabat are funded by the tobacco industry.[56].

Enstrom and Kabat have rejected this criticism, claiming that the American Cancer Society funded most of the first study, but pulled their funding at the last minute, forcing the researchers to look elsewhere to find funding. Further, they say were only able to find funding from a foundation funded by the tobacco companies. In response, ACS vice-president Michael Thun[57] asserts that Enstrom had been funded by the tobacco industry since 1997 without informing the ACS, and that Enstrom had communicated with Philip Morris about the potential value of the CPS-I follow-up as early as 1990.[58]

The study also attracted criticism for a number of methodological flaws:

  • It did not account for participants' considerable ETS exposure before California implemented a smoking ban in the late 1990s[59]
  • The analysis did not account for losses to follow-up, nor misclassification
  • The lower than usual relative risks for active smoking and coronary heart disease could have obscured the effect of ETS[60]
  • The participant group they used was designed to assess the effect of active smoking, not ETS[61]

Allan Hackshaw, deputy director of the cancer trials center at UCL, concluded "Enstrom and Kabat's conclusions are not supported by the weak evidence they offer, and, although the accompanying editorial alluded to 'debate' and 'controversy,' we judge the issue to be resolved scientifically, even though the 'debate' is cynically continued by the tobacco industry."

In addition, Enstrom and Kabat's work confirmed some harmful effects of secondhand smoke, in particular that it increased the risk of Chronic Obstructive Pulmonary Disease (COPD)[62].

The link between tobacco industry funding and the results of studies on the nature of passive smoking was investigated in a literature review by Barnes & Bero, who found that the only factor affecting the conclusions of epidemiological studies of passive smoking was whether the authors had recieved funding from the tobacco industry or not [63]. ASH published an analysis of the studies that concluded that the studies cannot be trusted, as there appears to be a direct conflict of interest. Alongside other faults, this analysis also criticizes the BMJ for failing to inform readers who funded the studies.[64]

Tobacco industry response

The passive smoking issue poses a serious economic threat to the tobacco industry. It has broadened the definition of smoking beyond a personal habit to something with a social impact, it has been the cause of successful litigation against employers by workers with a history of exposure to smoke, and it has resulted in various types of smoking restrictions. Accordingly, the tobacco industry have developed several strategies to minimise its impact on their business:

  • Libertarian: the industry has sought to position the passive smoking debate as essentially concerned with civil liberties and smokers' rights rather than with health.
  • Funding bias in research: in all reviews of the effects of passive smoking on health published between 1980 and 1995, the only factor associated with concluding that passive smoking is not harmful was whether an author was affiliated with the tobacco industry[65]
  • Delaying and discrediting legitimate research: Australia[66]
  • Promoting "good epidemiology" and attacking so-called junk science (a term popularised by industry lobbyist Steven Milloy): attacking the methodology behind research showing health risks as flawed and attempting to promote sound science [1]. Ong & Glantz (2001) cite an internal Phillip Morris memo giving evidence of this as company policy [67]

Smoking bans

See also: Smoking bans, List of smoking bans

As a consequence of the perceived dangers of passive smoking, a general ban on smoking in all establishments serving food and drink, including restaurants, cafés, and nightclubs, was introduced in Norway on June 1, 2004, and in Sweden on June 1, 2005, and many parts of America, including the states of Florida, California and New York, have similar legislation in place.

These initial bans have grown in scope, with countries (such as Ireland and Scotland), jurisdictions (like New York State, Washington State, and Arkansas in the US) now prohibiting smoking in public buildings as well as private businesses such as restaurants and clubs. Many office buildings contain specially ventilated smoking areas; some are required by law to provide them.

Some regions and local governments have banned smoking in all workplaces, in taxicabs, and in ventilated smoking rooms or enclosed smoking shelters such as those found in front of hospitals.

Even in countries traditionally seen as nations of smokers, opinion polls have shown support for bans, with 70% of those in France supporting a ban[39].

In the first 18 months after the town of Pueblo, Colorado enacted a smoking ban in 2003, hospital admissions for heart attacks dropped 27%. Admissions in neighboring towns without smoking bans showed no change. The American Heart Association said, "The decline in the number of heart attack hospitalizations within the first year and a half after the non-smoking ban that was observed in this study is most likely due to a decrease in the effect of secondhand smoke as a triggering factor for heart attacks." [68]

Notes

  1. ^ American Legacy Foundation factsheet on Secondhand Smoke (PDF); cited source there is Environmental Protection Agency.
  2. ^ Thomson NC, Spears M. (2005). "The influence of smoking on the treatment response in patients with asthma.". 'Curr Opin Allergy Clin Immunol' 5 (1): 57-63. PMID 15643345.
  3. ^ Jang AS et al (2004). "The effect of passive smoking on asthma symptoms,atopy,and airway hyperresponsiveness in schoolchildren.". J Korean Med Sci. 19 (2): 214-7. PMID 15082893.
  4. ^ Skorge TD, Eagan TM, Eide GE, Gulsvik A, Bakke PS. (2005). "The adult incidence of asthma and respiratory symptoms by passive smoking in uterus or in childhood.". Am J Respir Crit Care Med. 172 (1): 61-6. PMID 15805186.
  5. ^ Wafula EM, Limbe MS, Onyango FE, Nduati R. (1999). "Effects of passive smoking and breastfeeding on childhood bronchial asthma.". East Afr Med J 76 (11): 606-9. PMID 10734518.
  6. ^ Cantani A, Micera M. (2005). "Epidemiology of passive smoke: a prospective study in 589 children.". Eur Rev Med Pharmacol Sci. 9 (1): 23-30. PMID 15850141.
  7. ^ Eisner MD, Klein J, Hammond SK, et al. (2005). "Directly measured second hand smoke exposure and asthma health outcomes.". Thorax 2005 (60): 814-821. PMID 16192366.
  8. ^ US Department of Health and Human Services., The health consequences of involuntary smoking: report of the Surgeon General (DHHS Pub No (PHS) 87–8398), DHHS, Washington, DC (1986). PMID 3097495
  9. ^ National Research Council. Environmental tobacco smoke: measuring exposures and assessing health effects, NRC, Washington, DC (1986).
  10. ^ US Environmental Protection Agency., Respiratory health effects of passive smoking: lung cancer and other disorders, EPA, Washington, DC (1992).
  11. ^ California Environmental Protection Agency., Health effects of exposure to environmental tobacco smoke, California EPA, Sacramento (1997). PMID 9583639
  12. ^ Centers for Disease Control and Prevention (CDC). State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke--United States, 2000. MMWR Morb Mortal Wkly Rep. 2001 Dec 14;50(49):1101-6. id=PMID 11794619
  13. ^ Alberg AJ, Samet JM. Epidemiology of lung cancer. Chest. 2003 Jan;123(1 Suppl):21S-49S. PMID 12527563
  14. ^ In: P Boffetta, A Agudo and W Ahrens et al., Editors, Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe, J Natl Cancer Inst 90 (1998), pp. 1440–1450.
  15. ^ Report of the Scientific Committee on Tobacco and Health to the Chief Medical Officer, Part II. Retrieved on 2006-07-26.
  16. ^ Hackshaw AK. Lung cancer and passive smoking. Stat Methods Med Res. 1998 Jun;7(2):119-36. PMID 9654638
  17. ^ National Health and Medical Research Council. The health effects of passive smoking, Australian Government Publishing Service, Canberra (1997).
  18. ^ U.S. Surgeon General's report on Secondhand Smoke (Chapter 2; pages 30 - 46)
  19. ^ U.S. Surgeon General's Report on Secondhand Smoke (Chapter 8)
  20. ^ U.S. Surgeon General's Report on Secondhand Smoke (Chapter 5; pages 176 - 179)
  21. ^ The U.S. Surgeon General's Report on Secondhand Smoke (Chapter 5; pages 180-194)
  22. ^ U.S. Surgeon General's Report on Secondhand Smoke (Chapter 6; pages 311 - 319)
  23. ^ U.S. Surgeon General's Report on Secondhand Smoke (Chapter 9; pages 555 - 558)
  24. ^ U.S. Surgeon General's Report on Secondhand Smoke (Chapter 2; pages 46 - 49)
  25. ^ Bull, P.D. (1996). Diseases of the Ear, Nose and Throat. Blackwell Science. ISBN 0-86542-634-1.
  26. ^ U.S. Surgeon General's Report on Secondhand Smoke (Chapter 6; pages 376 - 380)
  27. ^ Janson C (2004). "The effect of passive smoking on respiratory health in children and adults.". Int J Tuberc Lung Dis 8 (5): 510-6. PMID 15137524.
  28. ^ Taylor R et al (2001). "Passive smoking and lung cancer: a cumulative meta-analysis.". Aust N Z J Public Health 25 (3): 203-11. PMID 11494987.
  29. ^ He J et al (1999). "Passive smoking and the risk of coronary heart disease—a meta-analysis of epidemiologic studies.". N Engl J Med 340: 920-6. PMID 10089185.
  30. ^ Svendsen KH, Kuller LH, Martin MJ, Ockene JK. (1987). "Effects of passive smoking in the Multiple Risk Factor Intervention Trial.". Am J Epidemiol 126: 783-95. PMID 3661526.
  31. ^ Glantz, S.A. & Parmley, W., "Passive Smoking and Heart Disease: Epidemiology, Physiology, and Biochemistry," Circulation, 1991; 83(1): 1-12. and Taylor, A., Johnson, D. & Kazemi, H., "Environmental Tobacco Smoke and Cardiovascular Disease," Circulation, 1992; 86: 699-702. This is found from Americans for Nonsmokers Rights; sources 11 and 12.
  32. ^ Review of epidemiological evidence by the Journal of the American Association. Retrieved on 2006-07-26.
  33. ^ The Helena Study (PDF). Retrieved on 2006-07-26.
  34. ^ Fact sheet published by the Victorian government (Australia). Retrieved on 2006-07-26.
  35. ^ Monographs Programme report on SHS. Retrieved on 2006-07-26.
  36. ^ Whincup PH et al. (2004). "Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement.". BMJ 329 (7459): 200-5. PMID 15229131.
  37. ^ Health effects of indoor air pollution. Retrieved on 2006-07-26.
  38. ^ Wirth et al. (2005). "Passive smoking". Rev Pneumol Clin. 61 (1 Pt 1): 7-15. PMID 15772574.
  39. ^ a b France to ban smoking in public. Retrieved on 2006-10-09.
  40. ^ International Agency for Research on Cancer (IARC) - Involuntary Smoking. Retrieved on 2006-07-17.
  41. ^ Snyder LA, Bertone ER, Jakowski RM, Dooner MS, Jennings-Ritchie J, Moore AS. (2004). "p53 expression and environmental tobacco smoke exposure in feline oral squamous cell carcinoma.". Vet Pathol 41 (3): 209-14. PMID 15133168.
  42. ^ Reif JS, Dunn K, Ogilvie GK, Harris CK. (1992). "Passive smoking and canine lung cancer risk.". Am J Epidemiol. 135 (3): 234-9. PMID 1546698.
  43. ^ International Agency for Research on Cancer (IARC) - Involuntary Smoking. Retrieved on 2006-07-17.
  44. ^ Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe.
  45. ^ Marc Kaufman. "Study: Secondhand Smoke Effects Pervasive", Washington Post, Tuesday, June 27, 2006.
  46. ^ Invernizzi G, Ruprecht A, et al. (2004). "Particulate matter from tobacco versus diesel car exhaust: an educational perspective.". 15333875 13 (3): 219-21. PMID 15333875.
  47. ^ Respiratory health effects of passive smoking: Lung cancer and other disorders.
  48. ^ CRS Report for Congress: Environmental Tobacco Smoke (PDF). Retrieved on 2006-07-26.
  49. ^ Detailed Contributor Breakdown, THOMAS J. BLILEY JR. (R-VA), 1994 election cycle (PDF). Retrieved on 2006-07-15.
  50. ^ Detailed Contributor Breakdown, THOMAS J. BLILEY JR. (R-VA), 1996 election cycle. Retrieved on 2006-07-15.
  51. ^ a b FDA can regulate tobacco as a device.(District Court judge rules Food and Drug Administration can regulate tobacco as a device for delivering nicotine). Retrieved on 2006-07-26.
  52. ^ The Straight Dope: Does second-hand smoke really cause cancer?.
  53. ^ The Straight Dope: Followup: Does second-hand smoke cause heart disease?.
  54. ^ Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98.
  55. ^ Environmental tobacco smoke and coronary heart disease mortality in the United States-a meta-analysis and critique, published in Inhalation Technology.
  56. ^ Tobacco industry publishes disinformation.
  57. ^ More misleading science from the tobacco industry.
  58. ^ Philip Morris Documents.
  59. ^ Vaidya JS (2003). "Passive smoking: study was flawed from outset". BMJ 327 (7413): 501. PMID 12946977.
  60. ^ Critchley J (2003). "Passive smoking: wider evidence needs to be interpreted". BMJ 327 (7413): 501. PMID 12946975.
  61. ^ Thun MJ (2003). "Passive smoking: tobacco industry publishes disinformation.". BMJ 327 (7413): 502-3. PMID 12946979.
  62. ^ Hedley AJ, Lam TH, McGhee SM, Leung GM, Pow M. (2003). "Passive smoking: secondhand smoke does cause respiratory disease.". BMJ 327 (7413): 502. PMID 12946981.
  63. ^ Why Review Articles on the Health Effects of Passive Smoking Reach Different Conclusions.
  64. ^ http://www.ash.org.uk/html/passive/html/BMJ0503critique.html.
  65. ^ Barnes DE, Bero LA (1998). "Why review articles on the health effects of passive smoking reach different conclusions". JAMA 279 (19): 1566-70. PMID 9605902.
  66. ^ Trotter L, Chapman S (2003). ""Conclusions about exposure to ETS and health that will be unhelpful to us": how the tobacco industry attempted to delay and discredit the 1997 Australian National Health and Medical Research Council report on passive smoking.". Tob Control 12 (Suppl 3:iii): 102-6. PMID 14645955.
  67. ^ Ong, E. & Glantz, S. (2001). ""Constructing "Sound Science" and "Good Epidemiology": Tobacco, Lawyers, and Public Relations Firmsg.". American Journal of Public Health 91 (11): 1749-1757. PMID 11684593.
  68. ^ Heart attacks decline after smoking bans CNN.com accessed 9/26/2006

External links

  • How dangerous is passive smoking? Article from BUPA, a healthcare organisation.
  • Website of tobacco.org; news and analysis supporting tobacco control
  • A critical view on the anti-tobacco movement
  • Collection of Anti-Smoking TV Commercials
  • FORCES International Claims that passive smoking is a fraud.
  • A single source for every original study published concerning passive smoking
  • Time Trends on Smoking and Health and the Value of the War on Tobacco This is original research.
  • Anti-smoking website
  • Anti-public smoking ban website
Search Term: "Passive_smoking"
second hand smoke news and second hand smoke articles

Here's our top rated second hand smoke links for the day:

Gaming Expo companies taking on second-hand smoke 

KVBC Las Vegas - Nov 15 11:33 PM
Some of the newest technology coming out of this year's Global Gaming Expo has nothing to do with betting and everything to do with second-hand smoke. Companies are taking on the challenge of clearing the air in smoke filled casinos.
Save

Second-Hand Smoke Battle Moves into the Home 
NPR - Nov 15 3:12 PM
News & Notes , November 15, 2006 · California has already outlawed smoking at restaurants, bars and some parks and beaches. Now some cities in the state are acting to stop cigarette smoke that drifts from someone's home into a neighbor's space.
Save

Second-Hand Smoke Battle Moves into the Home 
NPR - Nov 15 4:16 PM
California has already outlawed smoking at restaurants, bars and some parks and beaches. Now some cities in the state are acting to stop cigarette smoke that drifts from someone's home into a neighbor's space.
Save

Today is 30th year for Great American Smokeout 
Ironwood Daily Globe - Nov 16 2:45 PM
Today is the day designated by the American Cancer Society as the Great American Smokeout. The 2006 Surgeon General report declared that there is no safe level of second-hand smoke exposure.
Save

Research shows damage of second-hand smoke to pets 
The Edmond Sun - Nov 14 12:48 AM
Thursday will mark the 30th year of sponsorships by the American Cancer Society’s “Great American Smokeout” — which means no lighting up for one day.
Save

Thank you for viewing the second hand smoke page second hand smoke. 

secondhand smoke
secobd hand smoke
scond hand smoke
secon hand smoke
seccond hand smoke
second handsmoke
second hand smok
second had smoke

 

 Ever wondered what others are searching for in relation to second hand smoke? Now you can see.  Below is a listing of  what everyone else is searching for in regard to second hand smoke.

1. second hand smoke
2. effects of second hand smoke
3. can you test positive for thc from second hand smoke
4. second hand smoke statistics
5. positive thc from second hand smoke
6. drug test second hand smoke
7. health hazards of smoking and second hand smoke a time
8. side effects of second hand smoke
9. health effects of second hand smoke
10. second hand smoke asthma
11. hydrogen cyanide in second hand smoke
12. research on second hand smoke
13. second hand smoke and pets
14. second hand smoke risks
15. dangers second hand smoke
16. facts about second hand smoke
17. second hand smoke and babies
18. second hand smoke from cigarettes
19. second hand smoke from pot
20. second hand smoke junk science
21. effect of second hand smoke
22. second hand crack cocain smoke
23. second hand smoke video
24. surgeon general's report on the dangers of second hand smoke
25. why is second hand smoke a health problem
26. legal cases against second hand smoke
27. poisonous gases and chemicals and second hand smoke
28. problem of second hand smoke
29. second hand marajuana smoke
30. second hand smoke and children's health
31. second hand smoke and pet
32. second hand smoke and smoking
33. tenant rights second hand smoke
34. tenant rights second hand smoke nebraska
35. breathing neighbors second hand smoke
36. comments of students on second hand smoke
37. danger of second hand smoke
38. dangers of second hand smoke
39. deth certificates of people who died from second hand smoke
40. effects of second hand smoke on children
41. kids and second hand smoke
42. marijuana and second hand smoke and urine test
43. news and second hand smoke
44. reduces second hand smoke quickly
45. report on second hand smoke
46. second hand smoke and health
47. second hand smoke and seventh month pregnancy
48. second hand smoke baby
49. second hand smoke cause sids
50. second hand smoke deaths per year
51. second hand smoke during pregnancy
52. second hand smoke party
53. second hand smoke picture of child's lung
54. second hand smoke related deaths
55. second hand smoke reports
56. second hand smoke the truth
57. second hand smoke through touch
58. second hand smoke truths
59. significance of primary and second hand smoke to bronchitis
60. statistics on second hand smoke
61. surgeon general report affects of second hand smoke on hotel
62. surgeon general report affects of second hand smoke on maids
63. thc levels second hand smoke
64. articles on effects of second hand smoke
65. benefits of second hand smoke
66. can second hand marijuana smoke effect a drug test
67. cause of second hand smoke
68. causes of second hand smoke
69. children and second hand smoke
70. dangers from second hand smoke
71. dangers of second hand smoke and the law
72. effectof second hand smoke
73. effects eyes hand second smoke
74. effects of second hand smoke of marijuana
75. effects of second hand smoke video
76. facts about second hand smoke for children
77. getting rid of second hand smoke in the house
78. hand public restaurant second smoke
79. harmful effects of second hand smoke
80. how many people die from second hand smoke
81. how many people die of second hand smoke each year
82. how to write an outline about second hand smoke
83. judge decisiion against second hand smoke
84. lyrics to second hand smoke
85. myth second hand smoke
86. neighbors second hand smoke
87. no health risks of second hand smoke
88. pets and second hand smoke
89. pictures of the second hand smoke
90. pregnant woman second hand smoke
91. preventing employee exposure to second hand smoke
92. second hand smoke + lawyer
93. second hand smoke + risks
94. second hand smoke and boren
95. second hand smoke and fetal
96. second hand smoke and heart disease
97. second hand smoke and lung cancer
98. second hand smoke and pregnancy
99. second hand smoke and restless leg syndrom
100. second hand smoke best
101. second hand smoke bracelet
102. second hand smoke cancer
103. second hand smoke causes 3,400 lung cancer deaths per year
104. second hand smoke deaths
105. second hand smoke debate
106. second hand smoke diseases from
107. second hand smoke effects in public areas
108. second hand smoke engineer
109. second hand smoke law
110. second hand smoke lawsuits against employer
111. second hand smoke legislation
112. second hand smoke lesson plan
113. second hand smoke limb damage
114. second hand smoke lung cancer statistics
115. second hand smoke outline
116. second hand smoke picture
117. second hand smoke smokes you
118. second hand smoke smoking health effects htm
119. second hand smoke the band
120. second hand smoke to babies
121. second hand smoke what is in it
122. second hand weed smoke and tests
123. surgeon general report on second hand smoke
124. surgeon general second hand smoke
125. thc levels from second hand smoke
126. toxins in second hand smoke
127. urine test second hand smoke