Smoke Signals August 1990 Page 8
- HEALTH
Second Hand Smoke: Some Grim News
New Studies Suggest it's a
Leading Cause of Death
There's no denying that cigarettes are a lethal addic
tion: smoking kills more than six times as many Ameri
cans every year as died in the entire Vietnam War. But
secondhand smoke remains a source of bitter conten
tion. Is it really a public health hazard, as the antismok
ing forces contend? Or is it just an annoyance? Four
years ago, the U.S. Surgeon General's office and the
National Research Council tackled the question. In
separate reports, both firmly linked passive smoking to
lung cancer. They also found that smokers' children
suffered more than their share of respiratory infections.
But neither panel tried to gauge the overall impact of
passive smoking on the nation's health. The evidence
was still too sketchy.
That was four years ago. The big picture is now
becoming clearer, and two new studies suggest it's not
going to be pretty. In a draft report to be released this
month, the EPA will conclude that secondhand snibke is
causing 3,800 lung-cancer deaths in the United States
every year. If approved, the document will declare
airborne tobacco smoke a "class-A carcinogen" a .
substance known to cause cancer in humans. The second
new, study, by San Francisco heart researcher Stanton
Glantz, suggests that lung cancer is only the beginning of
the problem. Indeed, Glantz calculates that passive
smoking causes 10 times as much heart disease as lung
disease, making it the nation's third leading cause of
preventable death. The only bigger killers, he says, are
active smoking and alcohol abuse.
The new EPA report - based on results from 24
epidemiological studies, including 11 that weren't on
hand in 1986-could carry a lot political weight. An
accompanying "guide to workplace smoking policies"
will recommend that employers create separately
ventilated smoking lounges, since segregation alone
offers non-smokers little protection. The EPA doesn't
regulate cigarette smoke, but declaring it a known
hazard could make way for tough local smoking ordi
nances. Already, Los Angeles City Councilman Marvin
Braude has proposed an outright ban on smoking in
restaurants, saying the new studies take us "way beyond
the days when restaurant smoking laws were introduced
just to make dining a more pleasurable experience."
The Philip Morris company, a staunch opponent of
such restrictions, has launched a pre-emotive strike
against the EPA report but has succeeded mainly at
drawing attention to it. In a press release, the firm
implies that the EPA is neglecting a Yale University
study that tends to exonerate passive smoking. Though
that study, an unpublished 1987 Ph.D. dissertation, sug
gested that previous research may have overestimated
the danger, it actually supported "the existence of a
small-to-moderate effect of passive smoking on lung
cancer risks." And as Philip Morris concedes, the results
were not in a form that could be integrated into the
EPA's data pool. .
The dissertation relied on data from a research project
run by Yale epidemiologist Dwight Janerich, but it
wasn't the last word on the project. In a new paper,
summarized in the printed program of a recent cancer
conference, Janerich reported that the risk of lung
cancer nearly doubled in subjects who were exposed to a
given quantity of secondhand smoke during early life. By
estimating the number of people so exposed and
applying the risk factor, Janerich deduced that passive
smoking may be responsible for 20 percent of all lung
cancer in nonsmokers. That's a slightly higher estimate
than the EPA came up with. Philip Morris spokesman
Thomas Borelli speculates that Janerich "tortured the
data" until it said what he wanted to hear.
Heart disease: Lung cancer aside, the accumulating
. evidence on heart disease should give the industry pause.
By pooling and analyzing the results of 11 recent studies,
Stanton Glantz and his collaborator, Dr. William
Parmley, showed that living with a smoker has roughly
the same effect on heart-disease mortality than it has on
lung cancer mortality: both rise by about 30 percent in
the nonsmoker. But because heart disease is 10 times,
prevalent as lung cancer, the same risk factor yields
30,000 to 40,000 annual deaths. Combining that toll with
3,000 to 4,000 lung-cancer deaths, and factoring in an es
timated 10,000 deaths from nonlung cancers caused by
passive smoking, Glantz gets a grand total of about
50,000 deaths. In short, one nonsmoker dies for every
eight smokers.
Glantz is not the first scientist to reach this startling
conclusion; another researcher, Judson Wells, published
similar figures in 1988. But Glantz's paper is the most
comprehensive review to date, and it goes beyond
epidemiology to describe the mechanisms by which sec
ondhand smoke might affect the heart. Viewed as a
whole, he says, "the evidence on heart disease is
stronger today than the evidence on lung cancer was in
1986," One shudders to think what the next round of
studies will show.
- Courtesy of Newsweek
Parent's Smoke Gets Into Kid's Blood
Kids who are regularly exposed to a parent's cigarette
smoke may have an increased risk of developing heart
disease as a young adult. This is according to a study
done by researchers at the Medical College of Virginia
Hospitals.
. Should parents stop smoking around their children?
"Yes!" says William B. Moskowitz, M.D., a pediatric
cardiologist who led the research team.
Over two-hundred families with 11-year-old twins were
studied; in half the families at least one parent smoked.
The researchers found that children who were regu
larly exposed to one (or both) parent's smoke had lower
levels of HDL ("good cholesterol") in their blood.
The researchers also found that the red blood cells of
children regularly exposed to cigarette smoke were less
able to carry oxygen to the tissues.
The blood of children whose parents smoked also
contained two toxic chemicals: cotinine, a byproduct of
nicotine; and elevated levels of thiocyanate, a byproduct
of the cyanide present in cigarette smoke. Source:
The American Heart Association 's Journal,
Circulation, Vol 81, No. 2
Passive smoke and
heart disease linked
NEW YORK - Other people's smoke is a proven cause
of heart disease in non-smokers, raising their risk of
dying from the disease by up to 30 percent, a study says.
In a presentation in Boston at the World Conference
on Lung Health, Stanton Glantz of the University of
California, San Francisco, said research is beginning to
show exactly how cigarette smoke alters the heart, blood
and arteries. He presented a study in which he reviewed
others' research on the subject.
In 1986, the Surgeon General concluded in his annual
report on smoking and health that so-called passive
smoking causes lung cancer in non-smokers. At that
time, the evidence was insufficient to link passive
smoking with heart disease, the report said.
Newer studies have changed that, Glantz said Friday in
a telephone interview.
"The evidence that passive smoking causes heart
disease is stronger today than the evidence was in 1986
that passive smoking caused lung cancer," Glantz said.
Glantz's report comes one week after the Environ
mental Protection Agency said it will soon declare
environmental tobacco smoke a known carcinogen.
The EPA concluded that passive smoking causes 3,000
deaths. Glantz said passive smoking also causes 32,000
heart disease deaths.
"The heart disease deaths combined with the cancer
deaths make passive smoking the third leading cause of
preventable death, behind smoking and alcohol," he
said.
Glantz is a researcher and statistician who conducts
research in cardiology, has written two textbooks on
biostatistics and serves on the California State Scientific
Review Panel on toxic air contaminants.
His collaborator in the study was Dr. William Parmley,
a cardiologist, chief of the division of cardiology at
University of California, San Francisco, and a past
president of the American College of Cardiology.
The Tobacco Institute, which represents cigarette
makers, emphasized that the Surgeon General in 1986
had failed to find proof that passive smoking causes
heart disease.
"There have been only three studies since then, and
they continue to support the conclusions," Brennan
Dawson, a spokeswoman for the institute, said in a
telephone interview Friday.
- Courtesy of The East Oregonian