TOBACCO SMOKE --
HARMS & KILLS
Updated January 17, 2005
thanks to Dr. K. Heinz Ginzel for making this update possible!
on this page.
may be many
that people will accept secondhand -- but smoke is NOT one of
Smoke is so dangerous, it can even kill secondhand.
companies do not allow smoking around tobacco seedlings -- because it
them -- tobacco mosaic virus. Tomato
plants are also
also hurt and killed by secondhand smoke. For
this reason, more and more workplaces are going smoke-free. This
protects both the nonsmoker and the smoker from the devastating health
effects of secondhand smoke.
Smoking is hazardous -- to the smoker,
and to those who are forced to breathe the
smoke. This smoke is called secondhand smoke (SHS),
passive smoke, and environmental tobacco smoke (ETS).
ETS has immediate impacts on health,
can kill through triggering severe asthma attacks, heart
attacks, several cancers, and other illnesses.
ETS impacts the
brain and can disorient the breather, lowering test scores, affecting
reasoning and hand--eye relationships. There is no safe level of
exposure to ETS.
A most informative governmental report
from Ireland in 2002 on
ETS in the workplace, based on worldwide research, concluded that the
weight of evidence for lung cancer, cardiovascular, and respiratory
disease, and for adverse effects on reproduction calls for legislative
measures to protect employees from exposure to ETS at work.
A research team at Health Canada
found that working in bars and restaurants can triple lung cancer
risk. They also observed a dose-response relation between the
degree of exposure and lung cancer risk.
In the city of Helena, Montana (USA),
the number of heart attacks decreased substantially after the city
banned indoor smoking, but then rose quickly to its former level after
the law was struck down in court six months later. This event
prompted the US Centers of Disease Control and Prevention (CDC) for the
first time to warn people at risk of heart disease to avoid all
buildings and gathering places that allow indoor smoking.
In Western New York State (USA)
air pollution of RSPs (PM2.5) in a sample consisting of seven bars, six
bar/restaurants, five restaurants, two bowling alleys, a pool hall, and
a bingo hall dropped by 84% after implementation of the Clean Indoor
Air Law in 2003.
In New York City (USA),
"The city's bar and restaurant industry is thriving and its workers are
breathing cleaner, safer air," said a report issued by the Economic
Development Corporation and the Departments of Finance, Health &
Mental Hygiene and Small Business Services. Mike O'Neal, who
served as president of the N.Y. State Restaurant Association for 17
years, supported legislation for a comprehensive smoking ban. "I
feel strongly," he said, "that it is pro-business and pro-health to
eliminate smoking in all workplaces. We owe our workers a safe,
healthy work environment."
In the state of California (USA),
the strict smoking bans have led to a substantial decline in smoking
prevalence and also in the state's rates of heart disease, lung cancer,
and chronic obstructive pulmonary disease (COPD), which have fallen
well below the national average.
this Fact Sheet
on secondhand smoke
the following topics are considered:
nations recognize the lethal health dangers of tobacco smoke and
smoking in most workplaces, including restaurants and bars. These
in July, 2005, Sweden
-- The new law exempts bars and restaurants; enforcement begins 2007.
The county of Brondby in Denmark prohibits smoking in all public
NATIONS considering requiring
England -- November, 2004, the
Association (BMA) has called for smoke-free
Scotland -- November 2004, Scotland
McConnell, Scotland's first minister, has stated in the Scottish
Parliament that, "We will introduce a comprehensive ban on smoking in
enclosed public places," which he say should come into force in 2006.
Portugal -- although Portugal
is considering exempting bars, restaurants, and nightclubs
The United States of
does not have a plan to
protect people from the deadly effects of secondhand
in the USA which now require smoke-free workplaces are as follows:
Many cities, including
York City, also require smoke-free workplaces.
tobacco smoke (ETS) results
primarily from sidestream smoke and partly from exhaled mainstream
smoke is the smoke emitted by the burning end of the cigarette,
cigar, pipe, etc. between puffs. Mainstream
smoke is the smoke the smoker inhales.
There is no safe level of exposure to ETS.
single most important source of harmful indoor air pollution.
is no safe level of exposure to tobacco smoke.
separation of smokers and nonsmokers within the same air space is not
sufficient to protect nonsmokers.
read signs, and it does not stay in the "smoking" section.
Picture a swimming pool filled with water
which part is not chlorinated? Would you put up signs saying
"Chlorinated Area" and "Unchlorinated Area"?
Environmental Protection Agency has concluded that "Research
indicates that total removal of tobacco smoke through ventilation is
both technically and economically impractical."
If people are swimming at
one side of the swimming pool, and a child is urinating at the other
side of the swimming pool, would you put up signs saying, "Swimming
Area" and "Peeing Area"?
So it is with smoke in the
is not the answer to
protecting people from ETS.
British Medical Association
has declared that:
in America found that there was
50 times more air pollution in a smoky bar than in New York's
Holland tunnel at rush hour, and studies have found that ventilation
in bars does not reduce the risk to the health of customers or
industry has proposed that
ventilation is the solution to the problem of passive smoke,
however, scientific evidence proves that conventional ventilation
and air-cleaning systems do not provide effective protection
against the health hazards of second hand smoke.
systems use a filtration method to re-circulate air. However, while
this method can clear the smoky atmosphere, the toxins present in the
gas of second hand smoke remains.
matter and toxic gases of ETS remain suspended in the air of a room,
a car, and/or attached to walls, furnishings, and materials in the
room, long after smoking has ceased.
This can trigger health problems for people who enter that room, car,
The abstract on a
Fact Sheet on Secondhand Smoke, available at http://www.repace.com states:
secondhand-smoke causes morbidity and mortality from cancer, heart
disease, and respiratory disease, as well as acute sensory
irritation. It causes the premature death of hundreds of
thousands of nonsmokers worldwide. Smoke-free buildings are the
only remedy. Secondhand smoke cannot be controlled by
ventilation, air cleaning, or spatial separation of smokers from
tobacco smoke contains more than 4,000 chemicals and
approximately 60 carcinogens (cancer causing agents).
people are not sufficiently aware of their breathing, a largely
automatic process, to pay attention to what they breathe or how much
For an adult male, for example,
the average daily
intake of food is 1.5 kg,
that each year an estimated 2.25
million metric tons of gaseous and
inhalable particulate matter of ETS are discharged into our
is 2.5 kg,
but the amount of
exchanged by the lungs is as high as 15.0 kg.
Smoking creates a toxic waste dump in
that lingers long after the smoker has left the room, automobile, etc.
A low-tar filter cigarette may
increase health hazards for nonsmokers exposed to its smoke, as more mutagens may be released
through the burning end rather than through the filter tip.
are among the powerful poisons in ETS:
Nicotine is a
potent poison and is the precursor of the
lung carcinogen NNK. Nonsmokers
exposed to ETS carry the
lung cancer causing NNK, one of the most potent organ-specific lung
carcinogens known, in their bodies. The damage done by
carcinogens is permanent and may be cumulative. This is
one of the
tobacco-specific nitrosamines which arise from nicotine. The Clinical Toxicology of Commercial
Products, 5th edition, describes nicotine as "one of the most toxic of all poisons
acting with great rapidity."
is highly toxic and disables the oxygen
carrying capacity of the hemoglobin in red blood cells,
and is associated with heart
and fetal damage, for example.
is needed for nitrosamine formation.
is a respiratory and eye irritant.
is a ciliotoxic agent, and it is a respiratory irritant.
isocyanate is the lung poison known from the Bhopal disaster.
was used in rat poisons and in Nazi gas chambers.
was a toilet bowl disinfectant.
Particulates constitute the visible smoke which is even less
than 5% of the total effluent from a burning cigarette, and carries the bulk of
the carcinogens (cancer causing agents) which number approximately
60. The damage done to the body by the carcinogens is permanent.
tobacco smoke contains more than a hundred times the concentrations of
endotoxins that are present in average smoke free indoor
air. These endotoxins
arise from bacteria and can induce serious
inflammatory reactions and lead to bronchitis and asthma.
the carcinogens (cancer causing agents) in ETS are
impacts of ETS
Benzo [a] pyrene --
indicated in lung cancer
Nitrosamines -- cancer of lung,
respiratory system, and other organs
Aromatic amines -- cancer of the
bladder, cancer of the breast
Benzene -- leukemia
Formaldehyde -- nasal cancer;
used in embalming fluid
Polonium-210 -- radioactive --
immediately impacts the respiratory system and can trigger
attacks which may be severe enough to cause death. ETS can
to pneumonia, bronchitis, and
can trigger migraine headaches,
earaches, eye and throat irritation, and middle ear infections.
ETS can trigger
heart attacks and strokes.
Nicotine is changed into cotinine in
the body. In a study of
4,399 children aged 6 to 16, even the lowest exposure of ETS, as
monitored by the levels of cotinine, a metabolite of nicotine, in
blood, urine, saliva, and hair, was found to significantly impair, in a
dose related manner, the children's reading, math, and reasoning
other words, in children and teenagers, even low amounts of ETS can significantly
lower test scores by as much as 2-5 or more points and demonstrate a
decline in the skills of reading, math, reasoning, and logic.
level of exposure to ETS exists. Quoting
from that recent study, the authors
estimate that more than 33 million children in the United States are
exposed to levels consistent with the adverse effects seen in this
the United States, 43% of children are exposed to environmental
tobacco smoke in their own homes, and 85% of children have detectable
levels of cotinine in their blood."
(K.Yolton, et al. Exposure to
environmental tobacco smoke and cognitive abilities among U.S. children
and adolescents. Environmental Health Perspectives 113
(1): 98-103, 2005.)
Carcinogens cause damage to
the body which is permanent and can lead to cancer. There is no
level for carcinogens. Approximately 60 carcinogens are present
in tobacco smoke.
been definitely linked to several types of cancers including:
Breast Cancer --
the California EPA
2004 report conclusively links breast cancer to ETS.
Earlier studies on breast cancer had been inconclusive because of the
complexity of variables that needed to be controlled before statistical
significance could be achieved, such as menopausal status, age of
exposure to ETS, genetic susceptibility, and the hormone receptor
status of the tumor.
study reveals that women exposed to ETS
may be at greater risk for
cervical cancer. Published in the Obstetrics & Gynecology
Journal, 2005, the Johns Hopkins School of Medicine study noted
women who did
not smoke but who lived with someone who did smoke were
twice as likely to develop cervical tumors as women not exposed to
strong evidence that ETS is a cause of
of brain cancer and lymphomas in
EPA Report Update 2004
A recent study from the Johns Hopkins Bloomberg School of Public Health
states that the current EPA Assessment System for Population Exposure
Nationwide (ASPEN), which is being used nationally to assess the public
health impact of ambient air toxins, underestimates their
cancer risk by a factor of as high as three, when compared to
directly measuring indoor, outdoor, and personal exposures. (T.J.
Buckley, et al. Cancer health
risk significantly underestimated by EPA's ambient model
estimates. Journal of Environmental Health Perspectives
112: 589-598, 2004.)
note: The tobacco industry
lost its lawsuit challenging the
1992 U.S. Environmental Protection Agency Report which
as a Group A Human Carcinogen.
Federal Middle District Judge William
Osteen in 1998 ruled in favor of the industry. As a private
attorney in 1974, Osteen had worked for tobacco growers as a
appealed his ruling. The Fourth
Circuit Court of Appeals not
only dismissed Judge Osteen's ruling, but threw out the case against
the EPA altogether.
tobacco companies had
the option to
appeal to the U.S. Supreme Court, but failed to do so, probably
because they knew they would lose with so many credible scientific
studies that had reaffirmed that ETS causes cancer.
cartel had succeeded, however, in clouding
media reporting and the
understanding of the general public who still seemed to think
there was doubt about ETS causing cancer.
There are a
variety of web
sites which could have hidden ties to the tobacco companies and which
continue to cultivate doubt
about health hazards with articles sneering at reputable studies
and maintaining the "right" of smokers to smoke wherever they please
and to blow smoke in other people's airspace.
One out of every six
deaths from cardiovascular disease is caused by smoking, the leading
preventable risk factor. Smoke-free workplaces would
significantly reduce heart disease.
Disease (CHD) is causally
associated with ETS exposure.
The latest estimate of the annual death toll from ETS-related CHD in
the USA ranges from 22,700 to 69,600. Underlying conditions such
as diabetes, hypertension, or vascular disease worsen the risk.
-- ETS can contribute to stroke due
to atherosclerosis of the carotid
artery and the large arteries of the brain as well as the degeneration
of intracerebral arteries.
by which ETS affects the heart and blood vessels comprise
arterial wall thickening,
decrease in aortic
distensibility and reactivity, and
emerged as a major factor in CHD.
endothelial dysfunction, that
is, a functional impairment of the
linings of blood vessels, may finally explain why ETS can cause
greater damage to the cardiovascular system than one would have
expected simply by comparing the quantities of cigarette smoke to which
active and passive smokers are exposed.
A recent landmark
experiment in healthy young nonsmokers revealed that a mere 30 minute
exposure to ETS causes changes in coronary blood flow, specifically a
substantial reduction in the coronary flow velocity reserve, that are
indistinguishable from those of habitual smokers. These
are caused by nicotine which
inhibits the self-regulatory widening of
the coronary blood vessels (vasodilatation) in response to nitric
oxide, an endogenous agent released by endothelial cells. Since
this effect of nicotine reaches its maximum already in the small
amounts present in ETS, the difference between passive and active
smoking as to their effects on blood vessels is greatly narrowed.
By the same token, smoking of only 1 to 3 cigarettes per day can cause
heart disease by this mechanism.
contributing to heart disease and stroke are the adverse effect of ETS
on blood lipids: increase in "bad" cholesterol, LDL, decrease in
"good" cholesterol, HDL, as well as platelet activation and elevated
fibrinogen levels, all of which are associated with endothelial
damage and plaque formation leading to atherosclerosis that, in turn,
predisposes to coronary heart disease and stroke.
in children and in adults can be induced
and exacerbated by
exposure to ETS.
ETS aggravates episodes and severity of asthma attacks.
ETS causes more than 8,000 new cases of asthma in children each year.
As children grow, ETS significantly
reduces their lung capacity and
fetus and ETS --
Children and ETS
parent hurts the fetus.
The fetus is
hurt by smoke from the pregnant mother who smokes, and the ETS breathed
by the mother.
causes Dental Decay
ETS from either parent hurts infants
Pregnant women who smoke, or who are around ETS, may find serious
consequences for the fetus and later for the infant, such as:
low birth weight, a predictor of
frequent illness in the first year of
sudden infant death syndrome (SIDS)
cancer of the brain or lungs later
emotional as well as intellectual
deficits which have been traced past
This damage can be manifested in impaired
lung development, decreased
lung function, sudden infant death syndrome (SIDS), acute and chronic
respiratory illnesses (including otitis media), and the induction and
exacerbation of asthma.
exposure in pregnancy is responsible for a reduction in birth
weight which is associated with respiratory problems and perinatal
The danger of SIDS, the most common
cause of death in the first year of
life, greatly increases for infants whose parents smoke near them.
which impacts the brain during critical stages of its
intrauterine development in experimental animals, is a likely cause for
the deficits in learning and memory,
and the emotional and behavioral
problems seen in childhood and later in life.
nicotine also primes the adolescent brain for addiction.
reaching the fetus via the placental circulation can cause cancer later
findings in mice suggest that prenatal
ETS exposure may also promote
development of adult cardiovascular disease.
ETS increases the incidence of middle
ear effusion in children.
Heart disease risks go up as ETS
lowers kids' "good" cholesterol [HDL]
and increases the "bad" cholesterol [LDL].
Children suffer great physical and
psychological distress from ETS
of Pediatric Dental Caries With Passive Smoking
There is an association between environmental tobacco smoke and risk of
caries among children. Reduction of passive smoking is important not
for the prevention of many medical problems, but also for the promotion
of children's dental health.
The British Medical
Association (BMA) has called for
smoke-free workplaces and
smoke-free enclosed public places. Noting on their web site, http://www.bma.org.uk,
politicians in Ireland, Norway, and New
York have decided to put the health of their citizens first by banning
smoking in enclosed public places. Surely we have a right to ask
same from our Governments?"
Below are EXCERPTS
from the press release from the British Medical
(BMA), November 9, 2004, calling on the English Health Secretary, John
Reid, to set a date to ban workplace smoking in the United Kingdom.
stark BMA report, The Human
Cost of Tobacco, published today (9 November 2004),
doctors chronicle individual stories
behind the statistics to show
how second-hand smoke destroys lives and health.
year [in England]
at least 1000 people die from the effects of passive smoking. The BMA
believes the biggest single step governments can take to improve the
health of the public is to take action at national level to stop
smoking in enclosed workplaces.
foreword to the
report, BMA Chairman, Mr. James Johnson, offers the Health Secretary,
John Reid, the same advice as smokers get:
giving up smoking can be extremely difficult – like any addiction
kicking the habit is no easy task. When smokers decide to quit they
are often advised to set a date, bin the fags and then just do it.
Support from a doctor or health professional during this time can be
invaluable. I am going to give the same advice to John Reid.
the forthcoming White Paper for England, he should set a date for
banning smoking in all enclosed public places, this will give the
bars and restaurants time to bin their ash-trays and then these
workplaces will just have to abide by the law. John Reid already has
the support of the medical profession.
around 70 cases throughout the United Kingdom of doctors’
experiences of dealing with patients who have been exposed to
second-hand smoke. For example:
have had three confirmed cases of inoperable primary lung cancer in
life-long non-smokers in the last two years. The biopsies showed the
type of lung cancer only seen in smokers, and all three worked in
public places where they were heavily exposed to secondary cigarette
smoke. All three died within weeks of diagnosis.”
have recently seen a thirty-four year old
landlady with severe bronchial irritation and a history of recurrent
wheezy chest infections caused by her work environment in a smoky
pub. She now needs regular inhaled drugs including steroids to
control her symptoms. She herself has never smoked.”
saw a young boy on a number of occasions suffering from
severe asthma attacks. His mother said she could not think of
anything that brought on the attack, but the young boy said 'I always
get sick after seeing granddad'. Apparently his grandfather owns a
small and usually smoke filled restaurant.”
my current post in obstetrics I see numerous cases of low-birth weight
babies and difficult pregnancies exacerbated by passive smoking."
BMA has been calling for legislation to ban smoking in
enclosed public places since 1986.
agencies classify ETS as a human
The International Agency for Research on
Cancer (IARC) classified tobacco smoke as a human carcinogen --
a global recognition
World Health Organization --
another global recognition
on the Health Consequences of Involuntary Smoking, United States
Department of Health and Human Services (USDHHS), 1986
The National Academy of Sciences, USA
The National Cancer Institute, USA
The National Institute for
Occupational Safety and Health (NIOSH), USA
National Research Council of the
National Academy of Sciences, Report
on Environmental Tobacco Smoke, 1986, USA
U.S. Environmental Protection Agency,
1992 Report, endorsed and reprinted by the National Cancer Institute,
USDHHS, as Smoking and Tobacco Control Monograph 4, 1993.
California EPA, 1997, endorsed
and reprinted by the National Cancer Institute, USDHHS, as Smoking and
Tobacco Control Monograph 10, 1999, USA
California EPA Update, 2004 Draft
The U.S. Public Health Service
industry is the only industry which when confronted with
the illness, death, and devastation it causes to people and the
environment, refuses to stop manufacturing and marketing the
greedy drug pushers, they continue to
products and refuse to accept responsibility for their actions, blaming
the user, not the manufacturer, blaming the addict, not the ones who
made the product addictive.
so-called information on their web sites stating that the
products they make have been deemed by others to be harmful. Since they continue
to manufacture and advertise their products, this is apparently a legal
ploy to try to say that they have sufficiently warned every consumer,
so that no one can then sue them for any illness or death resulting
from the use of their products. This is immoral, obscene, and
shows a total lack of compassion for both their consumers -- the
smokers -- and those
bystanders, including children and adults, who are forced to breathe
the tobacco smoke.
This is not
an industry that exhibits corporate responsibility.
as evidenced by the items given below on this page, they
have in the past and continue to this day to try to intimidate
scientists and to discredit peer reviewed studies.
release from the International Agency for Research on Cancer
January 14, 2005
INDUSTRY UNDERMINING THE BASIS
OF TRUST IN SCIENCE
Press Releases http://www.iarc.fr,
industry undermining the basis of trust in
and colleagues publish in the current issue of
Lancet further revelations about Tobacco Industry subterfuge
employed to discredit scientific research, including work conducted
at the International Agency for Research on Cancer (IARC), and to
target specific scientists.
"The use of consultants, who
fail to declare their associations with the tobacco industry, to
publish purchased critiques of scientific research appears to remain
one of the key strategic approaches of the Tobacco Industry"
said Dr Peter Boyle, Director of the IARC. "Strategically
coordinated attacks by hired guns, hiding behind undisclosed paid
associations with industry, on the personal research of independent
scientists by such means is at best unethical and at worst cowardly."
in p53 tumour suppressor gene have been reported in
60% of lung tumours. Work published from 1996 onwards, based to a
large extent on IARC's p53 Database
demonstrated patterned mutagenic effect of benzo[a]pyrene, a
carcinogen present in tobacco smoke. "The
tobacco industry tried
to tamper with this evidence because of the implications in the
recognition of tobacco smoke as the cause of individual cases of lung
cancer. Their strategy of infiltrating the scientific community to
undermine the normal process of peer review and publication is
distressing for the scientists whose work is targeted. It is also
damaging for outstanding journals and academic institutions whose
record with respect to tobacco research might appear to be blurred by
the actions of a few individuals who maintained undisclosed tobacco
activity was supposed to be a
thing of the past following the U.S. Master Settlement in the late
1990s, but obviously this is not the case" noted Dr Boyle. "The
Tobacco companies claim that they are now working with the public
health community to support a single, consistent public health
message on the role played by cigarette smoking in the development of
disease in smokers."
the Tobacco Industry is
genuine in their recently proclaimed desire to work with the Public
Health community then they cannot expect any cooperation if they
continue to be involved in this and other similar activities. This
Industry needs to demonstrate true corporate social responsibility.
Until then, the public health community can have no confidence in the
actions of the Tobacco Industry, and academic institutions should
refuse any involvement with them, no matter how loudly the industry
claims that they will not interfere in the research."
IARC Communications Group
Agency for Research on Cancer
Industry Strategy to Undermine Research
77768 Contact: Wallace Ravven, email@example.com,
415-476-2557, University of California - San Francisco
launched a hidden campaign in the 1990s to change the standards of
proof needed to demonstrate that secondhand smoke was dangerous,
to an analysis of internal tobacco industry documents by researchers at
the University of California, San Francisco (UCSF). The "sound science"
standards they promoted through a variety of industry groups would have
made proving the hazards of secondhand smoke virtually impossible,
to the study.
involved a seemingly noble calling for "sound science", while rejecting
so-called "junk science" on secondhand smoke that actually threatened
industry's business interests.
public relations firms, Philip Morris sought to organize other
to participate in the "sound science" movement, masking its own
It also hired public relations and marketing firms to help form The
for Sound Science Coalition (TASSC), developed to look like a
organization of scientists and policymakers. Phillip Morris hoped TASSC
would seem like an independent body rejecting evidence that secondhand
smoke caused significant lung cancer and heart disease risk, according
to the analysis of the documents.
smoke restrictions had not yet been put in place, Philip Morris
a set of standards originally proposed by the Chemical Manufacturers
called "Good Epidemiology Practices." By modifying the proposal and
new opportunities to introduce it, Philip Morris sought to establish an
arbitrary threshold for identifying health risk from secondhand smoke -
a threshold higher than what scientists had found for secondhand smoke.
conclusions that an environmental toxin such as secondhand smoke was a
public health problem. This effort was particularly focused on
a large European epidemiologic study of passive smoking and lung cancer
being conducted by the International Agency for Research on Cancer at
time, the researchers found.
November issue of The American Journal of Public Health.
First author is
Ong, MD, a medical resident at Santa Clara Valley Medical Center who
the research while a medical student working in the Institute for
Policy Studies at UCSF. Her co-author is Stanton Glantz, PhD, a
faculty member of the Institute and a professor of medicine at UCSF.
independent seminars involving other industries and issues on the
"Good Epidemiology Practices" (GEP) were conducted in the United
United Kingdom, European Union and China, yet in all cases Philip
was connected to these events, the documents show.
appropriated the "sound science" concept to shape the standards of
and to prevent increased smoking restrictions, the authors state.
beyond 'creating doubt' and 'controversy' about the scientific
to attempting to change the scientific standards of proof," they write.
states, ignores the fact that a comprehensive assessment of risk
considering all the evidence related to a toxin, not just the
agrees that scientific work should be rigorously done, the scientific,
public health and regulatory community need to be more aware that the
science' and 'GEP' movement is not simply an indigenous effort from
the profession, but also reflects sophisticated public relations
controlled by industry executives and lawyers to manipulate the
standards of proof for the corporate interests of their clients," the
by the National Cancer Institute and the Richard and Rhoda Goldman Fund.
used in preparing this Fact Sheet include:
Aligne, et al., Association of Pediatric Dental Caries With Passive
Smoking, Journal of the American
Medical Association. 289 (10):1258-1264, March 12, 2003.
Aligne and J.J. Stoddard. An economic evaluation of the medical
effects of parental smoking. Archives of Pediatrics and Adolescent
Medicine 161:648-653, 1997.
Ambrosone, et al. Cigarette smoking, n-acetyltransferase 2 genetic
polymorphisms, and breast cancer risk. Journal of the American
Medical Association 276:1494-1501, 1996.
and Arias (2003). National Vital
Statistics Report 51(9), Table 2
for yr 2000 Ischemic heart diseases including AMI.
Press, "Judge Once Worked as Tobacco Lobbyist," New York
Times, August 23, 1995, p. D3.
Brennan, et al. Secondhand smoke exposure in adulthood and risk
lung cancer among never smokers: A pooled analysis of two large
studies. International Journal
of Cancer 109 (1):12-131, 2003.
Association, November 9, 2004, Press Release calling for a date to set
a ban on workplace smoking, http://www.bma.org.uk
T.J. Buckley, et al. Cancer
health risk significantly underestimated by EPA's ambient model
estimates. Journal of Environmental Health Perspectives
112: 589-598, 2004.
EPA. Health Effects of Exposure to Environmental Tobacco Smoke,
EPA Report Update 2004 Draft
CDC Advisory on
Heart Disease from ETS , Washington
Post, April 23, 2004.
Drews, et al. The relationship between idiopathic mental retardation
and maternal smoking during pregnancy. Pediatrics 97:547-553,
J.R. DiFranza and R.A. Lew. Effect
of maternal cigarette smoking on pregnancy complications and sudden
infant death syndrome. Journal of Family Practice 40:385-394,
Tobacco Industry Strategy to Undermine Research,
November 1, 2001
Farone, former Director of Applied Research for Philip Morris from
1976 to 1984. Prepared statement, "Toxic
Gas for the Masses,"
July 13, 1998.
Fichtenberg and S. A. Glantz. Association of the California Tobacco
Control Program with declines in cigarette consumption and mortality
from heart disease. New
England Journal of Medicine 343: 1772-1777,
G. Filippi, et al. Mothers'
active and passive smoking during pregnancy and risk of brain tumours
in children. International Journal of Cancer 57:769-774, 1994.
Gilpin, et al. Clean Indoor Air: Advances in California,
American Journal of Public Health
92: 785-791, 2002.
Ginzel. Testimony presented at the CDC Public Comments Meeting,
National Conference on the Healthy
People 2010 Tobacco Objectives,
Francisco, California, November 18, 2002.
Ginzel. Hazards smokers impose. New Jersey Medicine
S.A. Glantz and W.W. Parmley.
Passive smoking and heart disease: epidemiology, physiology, and
biochemistry. Circulation 83:1-12, 1991.
Benefits of Snuffing out Workplace Smoking Detailed by Stanford
Researcher, Ong. Business Wire, June 22, 2004.
Hecht. Carcinogen derived biomarkers: applications in studies of
human exposure to secondhand tobacco smoke. Tobacco Control
13: 148, 2004.
Hecht. Body turns nicotine into cancer chemical. Proceedings of
the National Academy of Sciences 97:12493, 2000.
Hecht. NNK-metabolites in first urine of infants born to smoking
mothers. American Chemical Society Press Release, August 23,
Hecht, et al. Metabolites of a tobacco-specific lung carcinogen in
the urine of elementary school-aged children. Cancer Epidemiology
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