Secondhand Smoke Summary from the 2006 Surgeon General’s Report

1. Secondhand Smoke Summary from the 2006 Surgeon General’s Report Jason Bergstrand, LSW Tobacco Prevention Coordinator Richland County Health Department

2. Surgeon General’s Report June 2006 • Previous SG Report was in 1986 • 20 years in the making • Over 600 scientist involved • This report reaffirms and strengthens the 1986 report • 6 major findings

3. Toxic Metals, Poison Gases and Cancer Causing Chemicals • Concentrations of many cancer-causing and toxic chemicals are higher in secondhand smoke than in the smoke inhaled by smokers (2006b). • Secondhand smoke contains more than 50 cancer causing agents (2006a,p. 12)& more than 4,000 chemicals (2006c, p. 5), including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide (2006b).

4. “Massive and Conclusive Scientific Evidence” “Massive and conclusive scientific evidence documents adverse effects of involuntary smoking on adults and children, including cancer and cardiovascular disease in adults, and adverse respiratory effects in both children and adults.” (2006a, p. iii).

5. #1Premature Death and Disease Secondhand smoke causes premature death and disease in adults and children who do not smoke. (2006a, p. 11).

6. Children at Risk#2 Children exposed to secondhand smoke are at increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in their children.

7. #3Adults at Risk Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. (2006a, p 11).

8. #4No Safe Level Exists There is NO risk free level of exposure to secondhand smoke. Breathing even a little can be dangerous.

9. Even a little… • Even a short time in a smoky room causes blood platelets to stick together. Secondhand smoke also damages the lining of blood vessels. In the heart, these bad changes can cause a deadly heart attack (2006c, p. 11).

10. …become sick and die… • Nonsmokers who breathe smoke at home or at work are more likely to become sick and die from heart disease and lung cancer (2006c, p. 11).

11. #5Ongoing Exposure Millions of Americans, both children and adults, are still exposed to secondhand smoke in their homes and workplaces despite substantial progress in tobacco control

12. Eliminating Exposure Fully #6is Needed for Protection • Eliminating smoking in indoor spaces fully protects nonsmokers from exposure to SHS. • Separating smokers from nonsmokers, • cleaning the air, and • ventilating buildings cannot eliminate exposures of nonsmokers to SHS. (2006a, p. 11)

13. Eliminating Exposure Fully is Needed for Protection Supporting Evidence (2006b) • Conventional air cleaning systems can remove large particles, but not the smaller particles or the gases found in secondhand smoke. • Routine operation of a heating, ventilating, and air conditioning system can distribute secondhand smoke throughout a building. • The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the preeminent U.S. body on ventilation issues, has concluded that ventilation technology cannot be relied on to control health risks from secondhand smoke exposure.

14. Importance of SF Policy “Smoke free policies are the most economic and effective approach for providing protection from exposure to secondhand smoke.” - Dr. Julie Louise Gerberding, Director, CDC USDHHS (2006, p. i). The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, Georgia: USDHHS.

15. SHS Kills… In 2005, it was estimated that exposure to secondhand smoke kills • more than 3,000 adult nonsmokers from lung cancer, • approximately 46,000 from coronary heart disease, and • an estimated 430 newborns from sudden infant death syndrome. (2006a, page i).

16. Exposure at Work or Home Increases Risk Nonsmokers who are exposed to SHS at home or at work increase their risk of • developing heart disease by 25 – 30% and • increase their risk of developing lung cancer by 20 – 30% (2006b).

17. SHS may also cause… • Scientists also believe secondhand smoke may cause other diseases throughout the body. Studies are being conducted on possible links to • Stroke • Breast Cancer • Nasal Sinus Cancer • And Chronic Lung Problems. • (2006c, p. 15)

18. Vulnerable Populations • SHS poses significant risks for people with lung and heart disease… even brief exposures could pose significant acute risks to older adults or to others at high risk for cardiovascular disease (2006a, p. iv).

19. Vulnerable Populations • Exposure to SHS tends to be greater for persons with lower incomes (2006a, p. 13). • Children, pregnant women, older people, and people with heart or breathing problems should be especially careful (2006c, p. 3).

20. Smoke-Free Effectiveness • Workplace smoking restrictions are effective in reducing SHS exposure (2006a, p. 16).

21. Effect of Smoke-Free Restrictions • Smoke-free laws appear to yield health benefits soon after implementation (2006a, p. 610) • Smoking restrictions have the potential to change employees’ smoking patterns by reducing opportunities to smoke, by altering workplace norms, and in some cases, by providing more access to employer-provided cessation services. (2006a, p. 611)

22. Effect of Smoke-Free Restrictions • Smoke-free policies… • Increase attempts to quit • Reduce # of cigs smoked daily • Continue to reduce # of cigs smoked after implementation • Increase the success rate of quitting - Contribute to decreases in youth smoking (2006a, p 612)

23. Other Impacts • Workplace smoking restrictions lead to less smoking among covered workers. (2006a, p. 14) and changes public attitudes about tobacco use from acceptable to unacceptable (2006a, p. i).

24. Arizona California Colorado Connecticut Delaware Hawaii Illinois Iowa Maine Maryland Massachusetts Minnesota Montana Nebraska New Hampshire New Jersey New Mexico New York Ohio Oregon Pennsylvania Rhode Island Utah Vermont Washington Washington D.C. Puerto Rico 25 States have Comprehensive Smoke-Free Laws, including Restaurants and Bars (2008 Tobacco Free Kids)

25. State Restaurant Associations Support “…state restaurant associations in several states have shifted from opposing state clean indoor air legislation to taking a neutral or even a supportive positions.” “…including not only restaurants, but also bars and gaming venues.” 2006a, p. 583

26. Arthur Schopenhauer Quote "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."

27. Recap Whether young or old, healthy or sick, secondhand smoke is dangerous. (2006c, p. 1).

28. “…involuntary exposure to SHS remains a serious health hazard that can be prevented by making homes, workplaces, and public places completely smoke-free.(2006a, Message from Michael O. Leavitt, Secretary of HHS)

29. “unlike some other public health hazards, secondhand smoke exposure is easily prevented. Smoke-free indoor environments are proven, simple approaches that prevent exposure and harm.” • Surgeon General Richard H. Carmona, 6/27/06, www.hhs.gov/news/press/2006press/20060627.html

30. Primary Sources for this Presentation USDHHS. (2006a). The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. USDHHS. (2006b).The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. 6 major conclusions of the Surgeon General Report. Retrieved July 5, 2006, from http://www.surgeongeneral.gov/library/secondhandsmoke/factsheets/factsheet6.html USDHHS. (2006c). The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Secondhand smoke what it means to you. Washington, DC: U.S. Government Printing Office. www.tobaccofreekids.org