Cancer Research UK : Briefing: secondhand smoke and smokefree public places

Briefing: secondhand smoke and smokefree public places

A bar-worker collects glasses in a smoke-filled pub. Cancer Research UK believes that all workplaces and enclosed public places should be smokefree. Breathing other people's tobacco smoke has been called "passive smoking, second hand smoking, involuntary smoking, and environmental tobacco smoke (ETS)". Tobacco smoke pollution is a more appropriate term. It consists of both sidestream (the smoke that drifts off the end of a burning cigarette) and mainstream smoke (the smoke that the smoker breathes in and then exhales). Nearly 85 percent of smoke in a room is caused by sidestream smoke, in which the concentration of toxins is much greater than the concentration that is 'filtered' through the length of the cigarette when the smoker smokes it.

What is in second hand tobacco smoke?

Tobacco smoke pollution is dangerous because it contains the same toxic substances as the smoke inhaled by smokers, including nicotine, acetone, ammonia, arsenic, benzene, beryllium, cadmium, DDT, formaldehyde, hydrogen cyanide, carbon monoxide, lead, mercury, methane, nickel, selenium, radio-active polonium-210, and at least 4,000 other chemicals. Many of these substances are known to cause cancer.

How dangerous is second hand tobacco smoke?

Passive smoking is not just irritating. It carries serious health risks, especially for children or those who are chronically exposed, which can include those who work in smoky workplaces.

Inhaling the smoke pollutants damages the lining of the arteries, makes the blood more likely to clot and increases levels of inflammatory markers in the blood. These adverse effects combine to increase the risk of clogged arteries, which can cause a heart attack.

In June 2002 the International Agency for Research on Cancer analysed all the significant published evidence relating to tobacco smoking and cancer - covering data from 12 European countries. The panel of experts - which included eminent Cancer Research UK researchers Sir Richard Doll and Professor Richard Peto - identified passive smoking as a cause of lung cancer and concluded that second hand smoke is carcinogenic to humans. They estimated that non-smokers who are exposed to second hand smoke are between 20 and 30 per cent more likely to develop lung cancer(1).

The Scientific Committee on Tobacco or Health (SCOTH) estimated there are several hundred lung cancer deaths a year and further deaths from heart disease caused by tobacco smoke pollution. There is also strong evidence that passive smoking significantly increases the risk of sudden infant death syndrome, respiratory illnesses such as asthma, and middle ear disease (2).

Tobacco smoke pollution is the only proven human carcinogen that is unregulated during working hours.

Cancer Research UK's position

The scientific evidence that breathing in second hand smoke is harmful has never been stronger. We believe that everyone has the right to breathe clean air. Cancer Research UK therefore supports a national ban on smoking in enclosed public places and workplaces, including restaurants and pubs that serve food.

Recent surveys show that over half of non-smoking employees are still exposed to tobacco smoke pollution at work, almost a third of them every day or most days. This amounts to about 8 million smokers and is despite that fact that employers have a statutory duty to maintain a safe working environment free of health risks. And in the same study NHS SmokeFree London also found that 88 percent of those asked - including 91 percent of non-smokers - want legislation to regulate workplace smoking(3).

Public place smoking bans work

Cancer Research UK believes a comprehensive national ban on smoking in workplaces should be introduced immediately. One American research study found that introducing totally smoke free workplaces, where none currently existed, can reduce overall smoking prevalence by around 4 percent(4).

Bans also reduce health problems, in a surprisingly short time. In the American town Helena, Montana, smoking was banned in all public buildings including restaurants, bars and casinos in 2002. Doctors at the local hospital noticed that heart-attack admissions were dropping within about six months by 58 percent (but there was no change in heart attack rates for patients who lived outside the city limits). Unfortunately the ban was overturned by tobacco lobbyists, whereupon heart-attack rates increased almost as quickly as they dropped(5).

And are likely to be popular

Public support for restrictions on smoking is high: 86 percent think smoking should be restricted at work, 88 percent in restaurants and 54 percent in pubs. The bans in New York and Ireland, now widely enforced and respected, show that it can be done.

Our "Clear the Air" campaign

Cancer Research UK has joined with other concerned charities - including ASH, Marie Curie Cancer Care, Quit and No Smoking Day - in the Clear the Air campaign. We are urging government to implement effective national legislation without delay, protecting people from exposure to dangerous second hand smoke in their workplace.

References

(1) International Agency for Research on Cancer. Monograph 83. Tobacco Smoke and Involuntary Smoking. Summary of Data Reported and Evaluation. Geneva, IARC, July 2002.

(2) Department of Health. Report of the Scientific Committee on Tobacco and Health. London, Department of Health, 1998.

(3) SmokeFree London. Workers still exposed to tobacco smoke at work. London, SmokeFree London, December 2003.

(4) Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 2002;325:188-191.

(5) Ellis R. Second hand smoke and the Helena story. New York Times, 17 October 2003. http://www.iht.com/ihtsearch.php?id=114030