Passive Smoking

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Inhalation of smoke in an enclosed space, especially for prolonged periods of time, is not healthy. It may trigger an asthmatic attack in a child, for example. There are studies that show if nonsmokers are in a 10 x 10 square foot room with smokers, within a short time of exposure, effects on the cardiovascular system, e.g., heart rate and blood pressure, can be observed. This is not surprising. Nicotine, after all, is a drug that can cause cardiovascular and central nervous system effects. The data for passive smoking causing lung cancer, however, are skimpy at

Figure 3-12. Risk chart for men who never have smoked. The chart indicates the number of men per 1000 who will die from various diseases and for any reason during the next 10 years, beginning at the indicated age. (*The numbers in each row do not add up to the chance of dying from any reason because there are many other causes in death in addition to the ones listed here.) Shaded area indicates age group and disease combinations with fewer than 1 death per 1000. (From Woloshin et al..151 with permission.)

Figure 3-12. Risk chart for men who never have smoked. The chart indicates the number of men per 1000 who will die from various diseases and for any reason during the next 10 years, beginning at the indicated age. (*The numbers in each row do not add up to the chance of dying from any reason because there are many other causes in death in addition to the ones listed here.) Shaded area indicates age group and disease combinations with fewer than 1 death per 1000. (From Woloshin et al..151 with permission.)

best. In a multicenter case-control study of exposure to environmental tobacco smoke (ETS) and lung cancer in Europe, no association between childhood exposure to ETS and lung cancer risk was found.154 There was weak evidence of a dose-response relationship between risk of lung cancer in spouses and workplace ETS, but no detectable risk after cessation of exposure. Similarly, no association between exposure to ETS and female breast cancer mortality was found in two large cohort studies, one involving over 146,000 women155 and one involving over 116,000 women.156

One of the most definitive studies involved 118,094 adults in California enrolled in late 1959 and followed until 1998.157 Of these, 35,561 were never smokers who had a spouse in the study with known smoking habits. No significant associations were found for current or former exposure to environmental tobacco smoke and coronary heart disease or lungcancer, even before or after taking into consideration seven potential confounding factors and before or after excluding participants with pre-existing disease. This was true for follow-up periods 1960-65, 196672, 1973-85, and 1973-98. The authors concluded that ''the association between exposure to environmental tobacco smoke and coronary heart disease and lung cancer may be considerably weaker than generally believed.''

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