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New Surgeon General's Report Focuses on the Effects of Secondhand Smoke
  from the HHS, june 27, 2006
U.S. Surgeon General Richard H. Carmona today issued a comprehensive scientific report which concludes that there is no risk-free level of exposure to secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. The finding is of major public health concern due to the fact that nearly half of all nonsmoking Americans are still regularly exposed to secondhand smoke.
The report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, finds that even brief secondhand smoke exposure can cause immediate harm. The report says the only way to protect nonsmokers from the dangerous chemicals in secondhand smoke is to eliminate smoking indoors.
"The report is a crucial warning sign to nonsmokers and smokers alike," HHS Secretary Michael Leavitt said. "Smoking can sicken and kill, and even people who do not smoke can be harmed by smoke from those who do."
Secondhand smoke exposure can cause heart disease and lung cancer in nonsmoking adults and is a known cause of sudden infant death syndrome (SIDS), respiratory problems, ear infections, and asthma attacks in infants and children, the report finds.
"The health effects of secondhand smoke exposure are more pervasive than we previously thought," said Surgeon General Carmona, vice admiral of the U.S. Public Health Service. "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." Secondhand smoke contains more than 50 cancer-causing chemicals, and is itself a known human carcinogen. Nonsmokers who are exposed to secondhand smoke inhale many of the same toxins as smokers. Even brief exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and increases risk for heart disease and lung cancer, the report says. In addition, the report notes that because the bodies of infants and children are still developing, they are especially vulnerable to the poisons in secondhand smoke.
"The good news is that, unlike some public health hazards, secondhand smoke exposure is easily prevented," Surgeon General Carmona said. "Smoke-free indoor environments are proven, simple approaches that prevent exposure and harm." The report finds that even the most sophisticated ventilation systems cannot completely eliminate secondhand smoke exposure and that only smoke-free environments afford full protection.
Surgeon General Carmona noted that levels of cotinine -- a biological marker for secondhand smoke exposure -- measured in nonsmokers have fallen by 70 percent since the late 1980s, and the proportion of nonsmokers with detectable cotinine levels has been halved from 88 percent in 1988-91 to 43 percent in 2001-02.
"Our progress over the past 20 years in clearing the air of tobacco smoke is a major public health success story," Surgeon General Carmona said. "We have averted many thousands of cases of disease and early death and saved millions of dollars in health care costs." He emphasized, however, that sustained efforts are required to protect the more than 126 million Americans who continue to be regularly exposed to secondhand smoke in the home, at work, and in enclosed public spaces.
To help communicate the report findings as widely as possible, the Surgeon General unveiled an easy-to-read guide with practical information on the dangers of secondhand smoke and steps people can take to protect themselves.
Copies of The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General and related materials are available on the Surgeon General's Web site at
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, U.S. Department of Health and Human Services
There is No Risk-Free Level of Exposure to Secondhand Smoke
The U.S. Surgeon General has concluded that breathing even a little secondhand smoke poses a risk to your health.

- Scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke. Breathing even a little secondhand smoke can be harmful to your health.
Secondhand smoke causes lung cancer.
- Secondhand smoke is a known human carcinogen and contains more than 50 chemicals that can cause cancer.
- Concentrations of many cancer-causing and toxic chemicals are potentially higher in secondhand smoke than in the smoke inhaled by smokers.
Secondhand smoke causes heart disease.
- Breathing secondhand smoke for even a short time can have immediate adverse effects on the cardiovascular system, interfering with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of heart attack.
- Even a short time in a smoky room can cause your blood platelets to become stickier, damage the lining of blood vessels, decrease coronary flow velocity reserves, and reduce heart rate variability.
- Persons who already have heart disease are at especially high risk of suffering adverse affects from breathing secondhand smoke, and should take special precautions to avoid even brief exposure.
Secondhand smoke causes acute respiratory effects.
- Secondhand smoke contains many chemicals that can quickly irritate and damage the lining of the airways.
- Even brief exposure can trigger respiratory symptoms, including cough, phlegm, wheezing, and breathlessness.
- Brief exposure to secondhand smoke can trigger an asthma attack in children with asthma.
- Persons who already have asthma or other respiratory conditions are at especially high risk for being affected by secondhand smoke, and should take special precautions to avoid secondhand smoke exposure.
Secondhand smoke can cause sudden infant death syndrome and other health consequences in infants and children.
- Smoking by women during pregnancy has been known for some time to cause SIDS.
- Infants who are exposed to secondhand smoke after birth are also at greater risk of SIDS.
- Children exposed to secondhand smoke are also at an increased risk for acute respiratory infections, ear problems, and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in their children.
Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate secondhand smoke exposure.
- The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the preeminent U.S. standard-setting body on ventilation issues, has concluded that ventilation technology cannot be relied on to completely control health risks from secondhand smoke exposure.
- Conventional air cleaning systems can remove large particles, but not the smaller particles or the gases found in secondhand smoke.
- Operation of a heating, ventilating, and air conditioning system can distribute secondhand smoke throughout a building.
Information contained on this highlight sheet has been taken directly from The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. For more information, please refer to the Resources and How to Protect Yourself and Your Loved Ones from Secondhand Smoke highlight sheets. Additional highlight sheets are also available at
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