Time to Go Smoke-Free?

A new Surgeon General’s report confirms the hazards of secondhand cigarette smoke

Is your workplace smoke-free? Most likely it is if you live in one of the growing number of states that have imposed bans on smoking in public places.

But if people are still allowed to light up around your office or other work sites, maybe it’s time to rethink your policies. A U.S. Surgeon General’s report, issued last December, confirms the danger of secondhand cigarette smoke.

This 30th report, from Surgeon General Dr. Regina Benjamin, is entitled How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease. You can read or download it at the National Institute for Occupational Safety and Health (NIOSH) website at www.cdc.gov/niosh.

 

Why another report?

NIOSH notes that in 1964, more than 50% of men in the United States smoked tobacco. Smoking was accepted essentially anywhere. Even Saturday morning cartoon shows had cigarette sponsors.

In January 1964, then-Surgeon General Luther Terry released the first Surgeon General’s Report, Smoking and Health, which concluded that smoking caused cancer.

Forty-five years and 28 more reports followed from various Surgeons General.

Why another report? “Despite 29 previous reports, tobacco use remains the leading cause of preventable death in the United States, and is responsible for 443,000 deaths each year,” NIOSH states. “Thirty percent of all cancer deaths are due to tobacco. Each day 1,200 lives of current and former smokers are lost prematurely due to tobacco-related diseases.”

 

Citing evidence

The new report presents a detailed, scientific look at the toxicology and biology behind nicotine addiction and tobacco smoking, including carcinogenic effects and the adverse effects on heart, lung and reproductive health. Among the basic findings:

1. There is no safe level of exposure to tobacco smoke. The evidence on the mechanisms by which smoking causes disease indicates that even low levels of exposure to tobacco smoke – including exposure to secondhand smoke – are dangerous. Low levels of exposure lead to a rapid and sharp increase in dysfunction and inflammation of endothelial cells (the layer of flat cells that line insides of blood vessels, lymphatic vessels, the heart and body cavities) that are implicated in acute heart attacks and formation of blood clots.

2. Damage from tobacco smoke is immediate. Evidence indicates that the risk does not increase in a linear fashion with increasing exposure, and even low levels of exposure to tobacco – such as a few cigarettes a day, occasional smoking, or secondhand smoke – can substantially increase the risk of adverse cardiac events.

3. There is no safe cigarette. There is not enough evidence that new modified cigarettes that lower emissions of specific toxicants in tobacco smoke reduce the risk for major adverse health effects.

 

Making changes

In a preface to the latest report, Surgeon General Benjamin states, “When individuals inhale cigarette smoke, either directly or secondhand, they are inhaling more than 7,000 chemicals: hundreds of these are hazardous, and at least 69 are known to cause cancer. The chemicals are rapidly absorbed by cells in the body and produce disease-causing cellular changes.

“This report explains those changes and identifies the mechanisms by which the major classes of the chemi­cals in cigarette smoke contribute to specific disease processes. In addition, the report discusses how chemicals in cigarette smoke impair the immune system and cause the kind of cellular damage that leads to cancer and other diseases. Insight is provided as to why smokers are far more likely to suffer from chronic disease than are nonsmokers.”

Tobacco remains the leading preventable cause of premature death in the United States. If your workplace still exposes people to secondhand smoke, perhaps it’s time to make a change. And perhaps your company’s health and safety programs should include provisions to encourage people to quit smoking – on the job or elsewhere – and provide support systems to help them quit if they want to.



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