Passive smokers are smoke inhalants, called passive smokers ( SHS ), or environmental tobacco smoke ( ETS ), by someone other than the "active" smoker in question. This happens when cigarette smoke penetrates any environment, causing inhalation by people in the neighborhood. Exposure to secondhand smoke causes diseases, disabilities, and death. The health risks of passive smoking are a matter of scientific consensus. This risk has been a major motivation for non-smoking legislation at work and public places in the room, including restaurants, bars and nightclubs, as well as some open public spaces.
Concerns over passive smoking have played a central role in the debate about the dangers and regulations of tobacco products. Since the early 1970s, the tobacco industry has seen public concern over secondhand smoke as a serious threat to its business interests. The damage experienced by the audience is considered as a motivator for tougher regulation of tobacco products. Despite industry awareness of the hazard of secondhand smoke in the early 1980s, the tobacco industry coordinated scientific controversy with the aim of stopping the regulation of their products.
Video Passive smoking
Effects
Epidemiological studies show that non-smokers exposed to secondhand smoke are at risk for many health problems associated with direct smoking. Much of the research comes from the study of nonsmokers married to a smoker. The conclusion is also supported by further research on occupational exposure to smoke.
In 1992, a review estimated that exposure to secondhand smoke was responsible for 35,000 to 40,000 deaths per year in the United States in the early 1980s. The increased risk of absolute heart disease due to ETS was 2.2%, while the percent of attributable risk was 23%. A 1997 meta-analysis found that exposure to secondhand smoke increased the risk of heart disease by a quarter, and two meta-analyzes in 1999 reached similar conclusions.
The evidence suggests that inhaled sidestream smoke, a major component of passive smoking, is about four times more toxic than primary cigarette smoke. This fact has been known to the tobacco industry since the 1980s, though it keeps its findings in secret. Some scientists believe that the risk of passive smoking, especially the risk of coronary heart disease, may have been substantially underestimated.
In 1997, a meta-analysis on the relationship between exposure to cigarette smoke and lung cancer concluded that the exposure caused lung cancer. The increased risk is estimated to be 24% among non-smokers living with a smoker. In 2000, Copas and Shi reported that there is clear evidence of publication bias in the studies included in this meta-analysis. They further concluded that after correcting the publication bias, and assuming that 40% of all studies were not published, this increased risk decreased from 24% to 15%. This conclusion has been challenged on the grounds that the assumption that 40% of all studies are not published is "extreme". In 2006, Takagi et al. Re-analysis of data from this meta-analysis to account for publication bias and estimate that the relative risk of lung cancer among those exposed to secondhand smoke was 1.19, slightly lower than originally estimated. A 2000 meta-analysis found a relative risk of 1.48 for lung cancer among men exposed to someone else's cigarette smoke, and a relative risk of 1.16 among those exposed at work. Other meta-analyzes confirm findings of an increased risk of lung cancer among women with exposure to others for next year's cigarette smoke. Found relative risk of lung cancer 1.29 for women exposed to secondhand smoke from their partners. A 2014 meta-analysis noted that "the relationship between cigarette smoke exposure and lung cancer risk is well established."
A small proportion of epidemiologists find it difficult to understand how passive smokers, which are thinner than actively inhaled fumes, can have an effect that is a big part of the risk of coronary heart disease among active smokers. One explanation put forward is that secondhand smoke is not just a "diluted" mainstream smoke version, but has a different composition with more toxic substances per gram of total particulate. Passive smoking seems to be capable of triggering acute manifestations of cardiovascular disease (atherothrombosis) and may also have a negative impact on the outcome of patients suffering from acute coronary syndromes.
In 2004, the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) reviewed all the significant published evidence linked to tobacco smoking and cancer. This concludes:
This meta-analysis shows that there is a statistically and consistently significant relationship between lung cancer risk in smokers and exposure to secondhand smoke from smoking couples. Excess risk is the order of 20% for women and 30% for men and remains after controlling some potential bias and confusing sources.
Subsequent meta-analysis has confirmed these findings.
The National Asthma Council of Australia cites research showing that passive smoking is probably the most important indoor contaminant, especially around children:
- Smoking by parents, especially by mothers, increases the risk of asthma in children.
- The outlook for early childhood asthma is less favorable in smoking households.
- Children with asthma who are exposed to cigarettes at home generally have more severe disease.
- Many adults with asthma identify ETS as a trigger for their symptoms.
- Asthma diagnosed by doctors is more common in non-smoking adults exposed to ETS than those not exposed. Among people with asthma, higher ETS exposure was associated with a greater risk of heavy attacks.
In France, exposure to secondhand smoke is estimated to cause between 3,000 and 5,000 premature deaths per year, with larger figures cited by Prime Minister Dominique de Villepin during his announcement of a national smoke-free law: "It makes up more than 13 deaths a day. This is an unacceptable reality in our country in terms of public health. "
There is evidence of good observation that smoke-free legislation reduces the amount of hospital admissions for heart disease.
Level of risk
The International Agency for Cancer Research The World Health Organization concluded in 2004 that there is sufficient evidence that passive smokers cause cancer in humans. Those who work in environments where unregulated smoke are at higher risk. Workers in particular at risk of exposure include those in the repair and maintenance of installation, construction and extraction, and transportation.
The US Surgeon General, in its 2006 report, estimates that living or working in places where smoking is allowed to increase the risk of non-smokers' develops heart disease by 25-30% and lung cancer by 20-30%. In the US, unsuccessful smokers have a risk of lung cancer about 20 times higher than those who never smoked.
Biomarkers
Environmental tobacco smoke can be evaluated either by directly measuring tobacco smoke pollutants found in the air or by using biomarkers, the indirect measure of exposure. Carbon monoxide monitored through the breath, nicotine, cotinine, thiocyanate, and protein are the most specific biological markers of exposure to tobacco smoke. Biochemical tests are a biomarker of exposure to secondhand smoke that is much more reliable than surveys. Certain groups of people are reluctant to disclose their smoking status and exposure to tobacco smoke, especially pregnant women and the parents of small children. This is because they are socially unacceptable. Also, it may be difficult for individuals to remember their exposure to tobacco smoke.
A 2007 study in the journal Addictive Behavior found a positive correlation between exposure to secondhand smoke and nicotine concentration and/or nicotine biomarker in the body. Significant biological nicotine levels from exposure to secondhand smoke are equivalent to nicotine levels of active smoking and levels associated with behavioral changes due to nicotine consumption.
Cotinine
Cotinine, nicotine metabolite, is a biomarker of exposure to secondhand smoke. Usually, cotinine is measured in blood, saliva, and urine. Hair analysis has recently become a non-invasive new measurement technique. Cotinine accumulates in hair during hair growth, which results in long-term size, cumulative exposure to tobacco smoke. The level of urinary cotinine has become a reliable tobacco biomarker that has been used as a reference in many epidemiological studies. However, the levels of cotinine found in urine reflect exposure only during the previous 48 hours. Gondinin levels in the skin, such as hair and nails, reflect tobacco exposure over the previous three months and are a more reliable biomarker.
Carbon monoxide (CO)
Carbon monoxide monitored by breath is also a reliable biomarker of exposure to secondhand smoke as well as tobacco use. With high sensitivity and specificity, this not only provides an accurate measure, but the test is also non-invasive, highly reproducible, and low-cost. CO breath monitoring measures the concentration of CO in respiration in parts per million, and this can be directly correlated with blood CO concentration (carboxyhemoglobin). CO Breath monitors may also be used by emergency services to identify patients suspected of having CO poisoning.
Maps Passive smoking
Pathophysiology
A 2004 study by the International Agency for Research on Cancer of the World Health Organization concluded that non-smokers are exposed to the same carcinogens as active smokers. Sidestream smoke contains more than 4,000 chemicals, including 69 known carcinogens. Particular concerns are polynuclear aromatic hydrocarbons, N-nitrosamine specialty tobacco, and aromatic amines, such as 4-aminobiphenyl, all known to be highly carcinogenic. Mainstream smoke, smoke sidestream, and passive smoking mostly contain the same components, but the concentration varies depending on the type of smoke. Several established carcinogens have been demonstrated by studies of tobacco companies themselves to be present at higher concentrations in sidestream smoke than in mainstream cigarette smoke.
Secondhand smoke has been shown to produce more polymer-particulate matter (PM) from low-emission diesel engine emissions. In an experiment conducted by the Italian National Cancer Institute, three cigarettes were left burning, one by one, in a 60 mÃ, gar garage with limited air exchange. Cigarettes produce PM pollution that exceeds the outdoor limit, and PM concentrations up to 10 times that of idling engines.
Exposure to secondhand tobacco smoke has a direct and substantial effect on blood and blood vessels in a way that increases the risk of heart attack, especially in people who are already at risk. Exposure to 30-minute tobacco smoke significantly reduces coronary flow rate reserves in healthy non-smokers. Passive smoking is also associated with vasodilation disorders in non-smoking adults. Secondary smoke exposure also affects platelet function, vascular endothelium, and tolerance of myocardial exercises at levels commonly found in the workplace.
Pulmonary emphysema may be induced in mice through acute exposure to sidestream cigarette smoke (30 cigarettes per day) for 45 days. Degranulation of mast cells that contribute to lung damage have also been observed.
The term "third hand smoke" was recently invented to identify residual contamination of cigarette smoke remaining after cigarettes were quenched and secondhand smoke cleared from the air. Initial research indicates that a by-product of the third smoke may pose a health risk, although the magnitude of the risk, if any, remains unknown. In October 2011, it was reported that Christus St. Hospital Frances Cabrini in Alexandria, Louisiana will attempt to eliminate secondhand smoke beginning in July 2012, and that employees whose clothing smells of smoke will not be allowed to work. This ban is enforced because the third cigarette smoke poses special hazards to the development of infants and young children.
In 2008, there were more than 161,000 deaths attributed to lung cancer in the United States. Of these deaths, an estimated 10% to 15% is caused by factors other than passive smokers; equivalent to 16,000 to 24,000 deaths annually. More than half of lung cancer deaths caused by factors other than first-hand smokers are found in nonsmokers. Lung cancer in non-smokers may be considered one of the most common cancer deaths in the United States. Clinical epidemiology of lung cancer has linked major factors closely related to lung cancer in non-smokers due to exposure to secondhand smoke, carcinogens including radon, and other indoor air pollutants.
There is a widespread scientific consensus that exposure to passive smokers is dangerous. The relationship between passive smokers and health risks is accepted by every major medical and scientific organization, including:
- World Health Organization
- US. National Institutes of Health
- Centers for Disease Control
- United States Surgeon General
- US. National Cancer Institute
- United States Environment Protection Agency
- California Environmental Protection Agency
- American Heart Association, American Lung Association, and American Cancer Society
- The American Medical Association
- American Academy of Pediatrics
- Australian National Health and Medical Research Council
- UK Scientific Committee on Tobacco and Health
Public opinion
A recent major survey conducted by the US National Cancer Institute and Centers for Disease Control has found widespread public awareness that passive smokers are dangerous. In surveys of 1992 and 2000, over 80% of respondents agreed with the statement that secondhand smoke is dangerous. A 2001 study found that 95% of adults agree that secondhand smoke is harmful to children, and 96% consider industrial tobacco to claim that second cigarette smoke is harmless to be dishonest.
A 2007 Gallup poll found that 56% of respondents felt that passive smoke was "very dangerous", a relatively stable figure since 1997. Another 29% believe that secondhand smoke is "somewhat dangerous"; 10% said "not too dangerous", while 5% said "not dangerous at all".
Controversy over damage
As part of efforts to prevent or delay tougher regulation of smoking, the tobacco industry funded a number of scientific studies and, where the results cast doubt on the risks associated with passive smoking, seeking broad publicity for the outcome. The industry also funded libertarian and conservative think tanks, such as the Cato Institute in the United States and the Institute of Public Affairs in Australia who criticized both scientific research on passive smoking and policy proposals to limit smoking. New Scientist and Journal of Public Health Europe have identified coordinated activities throughout the industry as one of the earliest expressions of corporate refusal. Furthermore, they claim that the disinformation propagated by the tobacco industry has created the denialism tobacco movement, sharing many characteristics from other forms of denial, such as the denial of HIV-AIDS.
Industry-funded study and criticism
Enstrom and Kabat
A 2003 study by James Enstrom and Geoffrey Kabat, published in the British Medical Journal, argues that the dangers of secondhand smoke have been exaggerated. Their analysis reported no statistically significant relationship between passive smokers and lung cancer, coronary heart disease (CHD), or chronic obstructive pulmonary disease, although the accompanying editorial noted that "they may over-emphasize the negative nature of their findings." The paper is widely promoted by the tobacco industry as evidence that the dangers of passive smokers are not proven. The American Cancer Society (ACS), whose database of Enstrom and Kabat was used to collect their data, criticized the paper as "unreliable or independent", stating that scientists at the ACS have repeatedly shown serious weaknesses in Enstrom and Kabat before publication. In particular, studies have failed to identify the comparison groups of "unexposed" people.
Enstrom's relationship with the tobacco industry has also attracted attention; in a 1997 letter to Philip Morris, Enstrom called for "substantial research commitments... so that I can compete effectively with the large volumes of epidemiological data and existing opinions on the health effects of ETS and active smoking." In the US extortion lawsuit against tobacco companies, Enstrom and Kabat's paper was quoted by the US District Court as "a prime example of how nine tobacco companies engage in criminal and fraud extortion to conceal the dangers of tobacco smoke." The court found that the study had been funded and administered by the Indoor Air Research Center, a front group of the tobacco industry tasked with "offsetting" destructive studies on passive smokers, as well as by Philip Morris stating that Enstrom's work is "clearly oriented litigation." 2005 at Tobacco Control states that the disclosure section of Enstrom's paper and the BMJ Kabat, while meeting the requirements of the journal, "does not fully disclose the relationship that the author has with the tobacco industry."
In 2006, Enstrom and Kabat published a meta-analysis of studies on passive smoking and coronary heart disease in which they reported a very weak association between passive smoking and death of heart disease. They conclude that exposure to secondhand smoke increases the risk of death from CHD by only 5%, although this analysis has been criticized for including two previous studies funded by industry suffering from a broad classification of exposure.
Gori
Gio Batta Gori, a spokeswoman and consultant for the tobacco industry and an expert in risk utility and scientific research, wrote in the librarian librarian Cato Institute Rules that "... of 75 published studies on ETS and lung cancer , about 70% did not report statistically significant and arguably statistically significant risk differences.17% claimed increased risk and 13% implied risk reduction. "
Milloy
Steven Milloy, a junk science commentator for Fox News and former consultant Philip Morris, claims that "from 19 studies" on passive smoking "only 8 - slightly more than 42% - reported a statistically significant increase in the incidence of heart disease. "
Another critic component cited by Milloy focuses on relative risk and epidemiological practice in the study of passive smoking. Milloy, who holds a master's degree from the Johns Hopkins School of Public Health and Public Health, argues that a study that yields a relative risk of less than 2 is a meaningless waste science. This approach to epidemiological analysis was criticized in the American Journal of Public Health :
The main component of an industry attack is the rise of campaigns to form "bars" for "sound science" that can not be fully met by most individual investigations, leaving studies that do not meet the criteria for dismissal as "waste science."
The affiliated tobacco industry and scientists also proposed a series of "Good Epidemiological Practices" that would have a practical effect to obscure the relationship between cigarette smoke and lung cancer; the personally stated objective of these standards is to "hinder harmful legislation". However, this effort was largely abandoned when it became clear that no independent epidemiologist organization would approve the standards proposed by Philip Morris et al.
Levois and Layard
In 1995, Levois and Layard, both tobacco industry consultants, published two analyzes in the journal of Toxicology and Pharmacology Regulations on the relationship between exposure to passive smokers and heart disease. Both papers reported no association between second hand smoke and heart disease. This analysis has been criticized for failing to distinguish between current and former smokers, despite the fact that former smokers, unlike today, are not at an increased risk of heart disease.
World Health Organization Controversy
A 1998 study by the International Agency for Research on Cancer (IARC) on environmental tobacco smoke (ETS) found "evidence of a dose-response relationship between lung cancer risk and ETS exposure and workplace."
In March 1998, before the study was published, the report appeared in the media alleging that the IARC and the World Health Organization (WHO) suppressed the information. The reports, appearing in the British Telegraph and The Economist, among other sources, allege that the WHO refrains from publishing its own report which supposedly fails to prove the relationship between passive smokers and a host of other diseases (especially lung cancer).
In response, the WHO issued a press release stating that the research results have been "completely misunderstood" in the popular press and in fact are very much in line with similar research showing the dangers of passive smoking. The study was published in the National Cancer Institute Journal in October of the same year, and concluded the authors found "no association between childhood exposure to ETS and lung cancer risk" but "found no evidence of weakness from the dose-response relationship between lung cancer risk and ETS exposure to the husband and wife and workplace. "The accompanying editorial is summarized:
When all the evidence, including important new data reported in this issue of the Journal, is assessed, the inevitable scientific inference is that ETS is a low-grade lung carcinogen.
With the release of tobacco industry documents classified under the Main Tobacco Settlement Agreement, it was discovered (by Elisa Ong and Stanton Glantz) that the controversy over the alleged crackdown on WHO data has been engineered by Philip Morris, British American Tobacco, and others. tobacco companies in an effort to discredit scientific findings that would jeopardize their business interests. The WHO investigation, conducted after the release of tobacco industry documents, found that the controversy was generated by the tobacco industry as part of a larger campaign to cut WHO budgets, distort scientific studies of passive smoking, and discredit WHO as an institution. The campaign is conducted using an independent front organization network and international and scientific experts with hidden financial relationships with industry.
EPA demands
In 1993, the United States Environmental Protection Agency (EPA) issued a report estimating that 3,000 lung cancer-related deaths in the United States are caused by passive smoking each year.
Philip Morris, R.J. Reynolds Tobacco Company, and groups representing tobacco growers, distributors and marketers take legal action, claiming that the EPA has manipulated this research and ignored accepted scientific and statistical practices.
The United States District Court for the Central District of North Carolina decided to support the tobacco industry in 1998, finding that the EPA has failed to follow proper scientific and epidemiological practices and has "cherry pick" evidence to support the conclusions they have committed to advance. The Court stated in part, "The EPA openly commits to conclusions before the study begins... adjusts the established procedures and scientific norms to validate the public conclusions of the Agency... In conducting the ETS Risk Assessment, ignoring information and making findings about selective information; disseminate significant epidemiological information, deviate from the Risk Assessment Guidelines, fail to disclose findings and important reasons... "
In 2002, the EPA successfully appealed this decision to the US Court of Appeals for the Fourth Circuit. The EPA petition was enforced on the initial reason that their report had no regulatory weight, and the previous findings were emptied.
In 1998, the US Department of Health and Human Services, through publication by the National Toxicology Program of Report 9 on Carcinogens, recorded environmental tobacco smoke among known carcinogens, observed the EPA assessment that "Individual studies are carefully summarized and evaluated."
Tobacco industry research funding
The role of the tobacco industry in funding scientific research on secondhand smoke has become controversial. A review of published research finds that tobacco industry affiliations are highly correlated with findings that liberate from passive smokers; researchers affiliated with the tobacco industry are 88 times more likely than independent researchers to conclude that secondhand smoke is harmless. In a specific example revealed by the release of tobacco industry documents, Philip Morris executives succeeded in encouraging a writer to revise his industry-funded review article to downplay the role of passive smokers in sudden infant death syndrome. The US Surgeon General 2006 report criticized the role of the tobacco industry in scientific debates:
The industry has funded or conducted research that has been assessed biased, supporting scientists to produce letters to editors who criticize research publications, attempt to undermine key study findings, assist in building a scientific society with journals, and strive to maintain controversy even when the scientific community reaches consensus.
The strategy was outlined at an international meeting of tobacco companies in 1988, in which Philip Morris proposed to form a team of scientists, organized by corporate lawyers, to "carry out work at ETS to keep the controversy alive." All scientific research is subject to supervision and "screening" by tobacco industry lawyers:
Philip Morris then expects the group of scientists to operate within the boundaries of decisions taken by PM scientists to determine the general direction of the research, which appears to be then 'filtered' by lawyers to eliminate the sensitivity areas.
Philip Morris reported that he put "... a large amount of funds into these projects... in an effort to coordinate and pay so many scientists internationally to keep the ETS controversy alive."
Tobacco industry response
Measures to address passive smoking poses a serious economic threat to the tobacco industry, after expanding the definition of smoking out of personal habits into something that has a social impact. In a secret report in 1978, the tobacco industry illustrated the growing public concern about secondhand smoke as "the most dangerous development for the continuity of the tobacco industry that has yet to occur." In United States v. Philip Morris et al. , District Courts for the District of Columbia found that the tobacco industry "... was recognized since the mid-1970s that the passive health effects of smoking pose a great threat to the viability of the industry and the profitability of cigarettes," and that the industry responded with " undermine and discredit the scientific consensus that ETS causes illness. "
Thus, the tobacco industry has developed several strategies to minimize the impact on their business:
- The industry has sought to position the former smoke debate as essentially related to civil liberties and the rights of smokers rather than to health, by funding groups such as FOREST.
- Funding bias in research; in all reviews of the effects of second-hand smoke on health published between 1980 and 1995, the only factor associated with concluding that non-hazardous passive smokers is whether an author is affiliated with the tobacco industry. However, not all studies that fail to find hazard evidence are by industry-affiliated authors.
- Delaying and discrediting legitimate research (see examples of how the industry is trying to discredit landmark Takeshi Hirayama's study, and for an example of how it tries to delay and discredit Australia's main report on passive smoking)
- Promoting "good epidemiology" and attacking so-called junk science: a methodology behind research that shows health risks as disabled and trying to promote healthy science. Ong & amp; Glantz (2001) cites the internal memo of Phillip Morris which provides this evidence as company policy.
- Creation of outlets for profitable research. In 1989, the tobacco industry established the International Society of Built Environment, which publishes peer-reviewed Indoor and Built Environment journals. This journal does not require disclosure of conflict of interest from the author. With documents available through Master Completion, it was found that the public executive council and the journal editorial board were dominated by paid tobacco industry consultants. The journal publishes a large amount of material on passive smoking, which is largely "industry-positive".
Citing the production of tobacco industry bias research and attempts to undermine scientific findings, the US Surgeon General 2006 report concludes that the industry has "sought to maintain controversy even as the scientific community reaches consensus... industry documents indicate that the tobacco industry has engaged in widespread activity... which has exceeded the limits of accepted scientific practice. "US District Court, at AS.A. v. Philip Morris et al. , found that "... despite their internal recognition of the dangers of passive smoking, the Defendant falsely denied that ETS caused the disease."
Position of large tobacco companies
The position of large tobacco companies on the issue of passive smokers varies somewhat. In general, tobacco companies continue to focus on the question of research methodology which shows that secondhand smoke is harmful. Some (such as British American Tobacco and Philip Morris) recognize the medical consensus that second cigarette smoke carries health risks, while others continue to assert that evidence is inconclusive. Some tobacco companies advocate for the creation of non-smoking areas in public buildings as an alternative to the comprehensive non-smoking law.
US extortion charges against tobacco companies
On September 22, 1999, the US Department of Justice filed a demand for extortion against Philip Morris and other large cigarette producers. Almost 7 years later, on August 17, 2006, US District Court Judge Gladys Kessler discovered that the Government had proven the case and that the defendants of the tobacco company had violated the RICO Corruption Inflicted Organizations Act (RICO). In particular, Judge Kessler found that PM and other tobacco companies have:
- plotting to minimize, distort, and confuse the public about the health hazards of smoking;
- publicly denied, while internally acknowledging that former tobacco smoke is harmful to people who do not smoke, and
- destroy documents related to litigation.
The ruling found that tobacco companies made a concerted effort to undermine and discredit the scientific consensus that passive smoking causes illnesses, especially by controlling research findings through paid consultants. The decision also concluded that tobacco companies are fraudulently denying the health effects of ETS exposure.
On May 22, 2009, a panel of three US Court of Appeal courts for the Circuit District of Columbia unanimously upheld a lower 2006 court ruling.
Non-smoking Act
As a consequence of the health risks associated with secondhand smoke, non-smoking regulations in public indoor spaces, including restaurants, cafes and nightclubs have been introduced in a number of jurisdictions, national or local, and some open areas. Ireland was the first country in the world to institute a comprehensive national smoke-free law on smoking in all indoor workplaces on March 29, 2004. Since then, many others have followed suit. Countries that have ratified the WHO Framework Convention on Tobacco Control (FCTC) have a legal obligation to implement effective law for protection from exposure to tobacco smoke in indoor workplaces, public transport, places publicly within the premises and, as appropriate, other public places. "(Article 8 FCTC) Parties to the FCTC have further adopted the Guidance on the Protection of the Second Smoke Exposure which states that" effective measures for provide protection from exposure to tobacco smoke... requires the total elimination of smoking and tobacco smoke in certain spaces or environments to create a 100% smoke-free environment. "
Polls have shown considerable support for smoke-free laws. In June 2007, a survey of 15 countries found 80% approval for a smoke-free law. A survey in France, supposedly a country of smokers, showed support for 70%.
Effects
The government's smoking ban leads to a decrease in the dangers of passive smoking including the decline of cardiovascular disease. In the first 18 months after the city of Pueblo, Colorado enacted a smoke-free law in 2003, hospital admissions for heart attacks declined 27%. Reception in neighboring cities without smoke-free legislation did not show any change, and a decrease in heart attack in Pueblo was caused by a reduction in exposure to secondhand smoke. The 2004 smoking ban applied in Massachusetts workplace reduced exposure to secondhand smoke from 8% of workers in 2003 to 5.4% of workers in 2010. The 2016 review also found benefits from decreasing exposure to smoke from certain location policies.
In 2001, a systematic review for the Community Prevention Services Guidelines acknowledged strong evidence of the effectiveness of the smoke-free policy and restrictions on reducing exposure to second-hand smoke. Following up on this review, identifying evidence in which the effectiveness of smoking bans reduces the prevalence of tobacco use. Articles published until 2005, are examined to further support this evidence. The studies examined provide sufficient evidence that a smoke-free policy reduces tobacco use among workers when implemented at work or by the community.
While a number of studies funded by the tobacco industry have claimed the negative economic impact of smoke-free legislation, there is no independent research funding that demonstrates such an impact. A 2003 review reported that independently and methodically funded research has methodologically consistently found no economic impact or positive impact of non-smoking legislation.
Air nicotine levels were measured in Guatemalan bars and restaurants before and after the smoke-free law was enacted in 2009. Nicotine concentrations were significantly decreased both in bars and restaurants measured. In addition, employee support for non-smoking workplaces increased substantially in post-implementation surveys compared to pre-implementation surveys. The outcome of this smoke-free law provides a much healthier work environment for staff.
Public opinion
A recent survey conducted by the Society for Nicotine and Tobacco Research demonstrates a supportive attitude toward the community, to a policy of non-tobacco smoke in the outer regions. Most communities support smoking restrictions in various open spaces. Reasons for responding to policy support are due to various reasons such as litter control, the establishment of a positive smoke-free role model for young people, reducing the opportunity for adolescents to smoke, and avoiding exposure to secondhand smoke.
Alternate form
Alternatives to non-smoking legislation have also been proposed as a means of harm reduction, particularly in bars and restaurants. For example, criticism of smoke-free laws states that research shows ventilation as a means to reduce tobacco smoke pollution and improve air quality. Ventilation has also been heavily promoted by the tobacco industry as an alternative to direct bans, through a network of independent experts with often anonymous industry ties. However, not all critics have connections to the industry.
The American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) formally concluded in 2005 that although fully isolated smoking rooms eliminate risk to non-smoking areas nearby, smoking bans are the only way to completely eliminating indoor health-related health risks. exposure. They further conclude that there is no effective dilution or cleansing system to eliminate risk. The General Surgeon General and the Joint Commission's European Research Center have reached the same conclusion. Implementation guidelines for the WHO Framework Convention on Tobacco Control states that engineering approaches, such as ventilation, are ineffective and do not protect against exposure to secondhand smoke. However, this no means that the action is useless in reducing the danger, only they fail to achieve the goal of reducing the exposure completely to zero.
Others have suggested a tradable smoking pollution permit system, similar to the trade and clearance system used by the Environmental Protection Agency in recent decades to curb other types of pollution. This will guarantee that some bars/restaurants in the jurisdiction will be non-smoking, while leaving the decision to market.
In animals
Various studies have been conducted to determine the carcinogenicity of environmental tobacco smoke in animals. These studies usually fall into the category of environmental tobacco smoke simulations, sidestream smoke condensate, or observational studies of cancer among pets.
To simulate environmental tobacco smoke, scientists expose animals to inhale cigarette smoke, which comes from a burning cigarette cone and through its paper, or a combination of mainstream smoke and sidestream. The IARC monograph concluded that mice with prolonged exposure to environmental tobacco smoke simulations, ie 6 hours a day, 5 days a week, for five months in the next 4 months before dissection, would have significantly higher incidence and lung tumor diversity compared with the control group.
The IARC monograph concluded that the sidestream smoke condensate had a significantly higher carcinogenic effect in mice than the main smoke condensate.
Observational study
Secondhand smoke is popularly recognized as a risk factor for cancer in pets. A study conducted by Tufts University School of Veterinary Medicine and University of Massachusetts Amherst linked the occurrence of cat cancers with exposure to environmental tobacco smoke through p53 gene overexpression. Another study conducted at the same university concluded that cats living with smokers were more likely to get cat lymphoma; the risk increases with the duration of exposure to secondhand smoke and the number of smokers in the household. A study by Colorado State University researchers, who looked at dog lung cancer cases, is generally unconvincing, although the authors report a weak association for lung cancer in dogs exposed to environmental tobacco smoke. The number of smokers in the home, the number of packs of cigarettes in the home per day, and the amount of time the dogs spend inside the house has no effect on the dog's risk for lung cancer.
Terminology
In 2003, "passive smoking" was the most commonly used term for the smoke of others in English-language media. Other terms used include "environmental tobacco smoke", while "secondhand smoke" and "secondhand smoke" are used to refer to exposure to secondhand smoke. The term "environmental tobacco smoke" can be traced back to a 1974 industry-sponsored meeting held in Bermuda, while the term "passive smoker" was first used in the title of a scientific paper in 1970. The Surgeon General of the United States prefers to use the phrase "smoker passive "rather than" environmental tobacco smoke ", which states that" The former descriptor "captures the nature of unintentional exposure, while the" environment "does not." Most researchers consider the term "passive smoking" to be synonymous with "cigarette smoke". In contrast, a 2011 comment on the Environmental Health Perspective believes that research on "third cigarette smoke" makes it inappropriate to refer to passive smokers with the term "passive smokers", which the authors say is a pro poto toto.
See also
- Tobacco health effects
- Cigarette smoke
- Permit tradable trade pollution
- Tobacco Control
- Philip Morris v. Uruguay
References
External links
- Scientific body
- The tobacco industry
- More links
Source of the article : Wikipedia
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