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Secondhand smoke kills one person for every 52 smokers

Secondhand smoke kills one person for every 52 smokers, study says. That’s a million people worldwide each year

(CNN)It took a mere 52 smokers to kill one person via secondhand smoke in 2016, according to a new analysis of worldwide statistics on the impact of smoking.

Considering there are an estimated billion smokers in the world, that means a million people die each year simply by inhaling the smoke around them, according to the study published Tuesday in the journal JAMA Network Open.

“There’s a sense of secondhand smoke being benign, or not as damaging as the actual smoking is,” said study co-author Dr. Jagat Narula, associate dean of global affairs at the Icahn School of Medicine at Mount Sinai in New York City.

“But it’s truly deadly,” Narula added.

“This study confirms what other research has shown: That nonsmokers are at risk from secondhand smoke and that no one should be exposed to it,” said Dr. Albert Rizzo, chief medical officer for the American Lung Association, who was not involved in the study.

“While it may be called ‘secondhand,’ the health effects of those exposed are truly firsthand,” Rizzo said.

Role of smokers

Secondhand smoke is defined as the mixture of the smoke breathed out by the smoker combined with the smoldering end of a cigarette, cigar or pipe. According to the United States National Library of Medicine, secondhand smoke contains more than 7,000 chemicals, 70 of which are known to cause cancer and hundreds more are toxic.

Even a low dose of secondhand smoke can contribute to sudden infant death and cause ear infections and asthma attacks in children while causing cancer and heart disease in adults.

“In 2006 the US Surgeon General declared there was no safe level of exposure to secondhand smoke,” Rizzo said.

While the harmful effects of secondhand smoke have been known for years, no one knew the full impact on deaths on a global basis, Narula said.

“We wanted to calculate how many smokers are needed to kill one innocent nonsmoker,” he said.

The Mount Sinai researchers worked in tandem with colleagues at the Amsterdam Medical Center, Amsterdam UMC, to analyze a number of datasets from the World Health Organization, the Global Burden of Disease Reports, International Mortality and Smoking Statistics and others.

They looked at the number of active smokers and secondhand smoke victims over a 26-year period from 1990 to 2016.

They developed a “secondhand smoke index” and applied it to North America; South Asia; Middle East and North Africa; East Asia and Pacific; Europe and Central Asia; Sub-Saharan Africa; Latin America and the Caribbean.

Globally, in 1990 it took only 31 smokers to kill one person; in 2016 that number rose to 52 smokers, the study found — an improvement due to smoking bans in restaurants, business and the like in some countries.

North America had the most favorable secondhand smoke index: around 86 smokers for each death. The Middle East and Southeast Asia had least favorable numbers due to few protective measures — around 43 smokers to one death.

More protections needed, study says

Despite the advances in some countries, the absolute number of people who smoked between 1990 and 2016 has been on the rise, the study says. That’s mostly due to the increase in smoking in China and India and other low-to-middle income countries, a trend which is expected to continue.

“This study demonstrates the devastating effect of secondhand smoke,” Narula said. By putting the blame for deaths directly at the feet of smokers, he added, this study will hopefully “influence public opinion against secondhand smoke exposure” and encourage governments to pass and enforce “stringent” anti-tobacco controls.

While developing countries need to step up their game, there is still much to be done in the US and other developed countries, said lead author Dr. Leonard Hofstra, a professor of cardiology at Amsterdam UMC.

“There is a lot to gain when it comes to strengthening policies to protect nonsmokers, especially children,” he said. “For example, it should not be allowed for parents to smoke inside their cars with them.”

Twenty-two states in the US have “not yet passed comprehensive laws protecting their citizens — and the Lung Association calls on them to do so,” Rizzo said, adding that the public can also make use of online tools provided by the American Lung Association “to end their addiction.”

CNN reached out to various tobacco companies for their response but did not hear back before our publication deadline.

It’s not safe to sit near smokers

Sitting near smokers in the cinema exposes you to up to ten cigarettes’ worth of smoke, a study suggests.

Researchers found that smokers can carry hazardous compounds from cigarette smoke on their clothes and skin — third-hand smoke — that is then released.

The study, carried out at Yale University, raises questions about whether regulations creating non-smoking areas do enough to minimise the risks of second and third-hand smoke.

Researchers tracked thousands of compounds in a cinema screening room over a week. They found that the volatile organic compounds found in tobacco smoke rose dramatically when audiences arrived for a film. Despite the screening room being a well-ventilated non-smoking area, the amounts were the equivalent of smoking between one and ten cigarettes in an hour.

This is the first study to demonstrate real-world third-hand smoke emissions in an indoor non-smoking environment. Years of research have shown that no level of exposure to cigarettes is safe. Public health initiatives focused on reducing second-hand exposure by banning smoking in public places, but the latest research, published in Science Advances, shows that even with no cigarette present, people are at risk of inhaling evaporated gases or dust that settles on surfaces after smoking.

Drew Gentner, associate professor of chemical and environmental engineering at Yale, said: “People are substantial carriers of third-hand smoke contaminants to other environments. The idea that someone is protected because they’re not directly exposed to second-hand smoke is not the case.”

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Onam to see tobacco smoke-free zones bloom in the capital city

Ahead of the frenetic festival and wedding season, florists in the city have decided to make their shops tobacco smoke-free. The decision, taken by the Trivandrum Florists Association, seeks to protect the environs of its 600 member families and the health and well-being of thousands of customers.

Passing the resolution – in line with the Indian tobacco control law COTPA’s prohibition of smoking in public places – at its annual Onam gathering on Wednesday, the association also decided to set up statutory warning boards in member shops.

Association President M Vairavan Pillai presided over the function. General Secretary C Sasidharan Nair, Treasurer Haridas, Vice Presidents C Sukumaran Nair, K Radhakrishnan and S Ambika and Joint Secretaries S Sreekumaran Nair, T Suresh Kumar, T Manikantan and J Reena were also present.

Number of children exposed to second-hand smoke halved

The Scottish Government published its national tobacco strategy in 2013.

The proportion of children exposed to second-hand smoke at home has almost halved in the last five years.

An NHS Scotland and Edinburgh University review of the Scottish Government’s tobacco control strategy also found a “downward trend in smoking prevalence”.

It also warned smoking continues to be a bigger problem in more deprived areas.

The Scottish Government’s national tobacco strategy, Creating a Tobacco Free Generation, was published in 2013.

The review found the strategy had a positive impact, with smoking rates among adults now at 20% compared to 31% in 2003.

The proportion of children exposed to second-hand smoke at home fell from 11% to 6% between 2014 and 2015.

Smoking rates in the most deprived areas were found to be at 35%, compared to 10% in the most affluent areas.

Dr Garth Reid, principal public health adviser at NHS Health Scotland said: “The evidence shows the positive impact of tobacco policy, ranging from the display ban which put tobacco out of sight in small shops and supermarkets to the introduction on smoke free NHS grounds.

“Yet, levels of smoking are still highest in Scotland’s most deprived areas, with 35% of people living in the most deprived areas smoking compared to ten percent in the most affluent areas.

“It is clear that further action to reduce inequalities in smoking is necessary if the aim of making Scotland tobacco-free by 2034 is to be achieved.”

Dr John McAteer, senior research fellow at Edinburgh University, said: “One of the aims of the 2013 tobacco control strategy was to reduce second hand smoke exposure among children by 2020.

“The most recent Scottish Health Survey shows that second hand smoke exposure fell from 11% to 6% between 2014 and 2015.

“This equates to 50,000 children having been protected from the harms of daily second-hand smoke exposure at home.

“Scotland has some of the most progressive tobacco control policies in the world, and Scottish smoking rates have fallen from 31% in 2003 to 21% in 2015.”

Raise tax on tobacco and make smokers pay for health costs

I support Gauri Venkitaraman’s plea for bans in public areas where the permeation of cigarette smoke is harmful for passers-by or those trying to enjoy the outdoors (“Smoking in public leaves even non-smokers in Hong Kong facing serious health risks [1]”, July 11).

Non-smokers in proximity risk having their asthma flare up. Curious toddlers could become poisoned by ingesting carelessly discarded butts.

The fire contagion risk posed by still-burning cigarette ends is well known during the height of Australia’s bush-fire-prone sizzling summer and hot summers elsewhere.

Less smoking means fewer discarded butts posing a fire hazard. Another reason to impose smoking bans is to prevent adverse lifestyle role modelling for impressionable children.

From a public health perspective, raising tobacco sales tax is likely to reduce daily cigarette consumption and, more importantly, dissuade adolescents from taking up smoking. The cost disincentive of a higher tax holds the potential to improve the community burden of heart and lung disease that consumes avoidable health-care outlays.

It’s about time smokers who adopt unhealthy life habits subsidised the huge expense incurred in treating the acute exacerbation of chronic lung disease, pulmonary community rehabilitation as well as stents and bypass surgery required to alleviate coronary artery disease. Smokers have an addiction requiring an external agency to help them give up.

Imposing higher taxes on fast food and alcohol offers opportunities to improve public health related to “diabesity” (diabetes plus obesity), alcohol-related trauma and interpersonal violence. If we can extend sales tax disincentives to fast food and alcohol, then claims that a tobacco tax discriminates against smokers cannot be justified.

Joseph Ting, associate professor, School of Public Health and

Social Work, University of Queensland, Brisbane, Australia
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Smoking in public leaves even non-smokers in Hong Kong facing serious health risks

Cigarette smoking definitely seems to be on the rise in Hong Kong. I commute to and from work by bus and, of late, the amount of second-hand smoke in the vicinity of bus stops has increased substantially.

There are huge rubbish bins near every bus stop, and people seem to view this as indicating a smoking spot. There have been many instances when I’ve found people smoking while waiting at the bus stops as well. Many times, people simply throw their half-smoked cigarettes in the little receptacle on top of the bins, without stubbing them out. This results in a continuous cloud of cigarette smoke billowing from the many burning stubs on top of the bins.

The other day, I found two schoolchildren hanging around a rubbish bin and one of them was about to surreptitiously pick up one of the burning stubs that someone had tossed away. Kids are, by nature, curious, and burning stubs lying within reach pose the danger of tempting them to try smoking.

Inhaling second-hand smoke is also very harmful and could lead to serious health issues down the line. Humans can be self-indulgent but usually the ill-effects are restricted to that individual. However, when it comes to smoking in public, the ill-effects are not restricted to the smoker. The negative effects of passive smoking has an impact on other people too, an impact that is scientifically proved to be tangible, measurable and, at times, permanent.

Just imposing high tobacco taxes has not really had an impact, as far as pedestrians being forced to inhale second-hand smoke goes. A legal move to increase the size of warnings on the cigarette packs has met with fierce resistance, accompanied by lobbying by tobacco executives and their lawyers.

Many countries have enforced compulsory, graphic health warning signs covering most of the surface area of cigarette packs, along with plain packaging that reduces the effect of branding for drab-looking packs.

The government has laws in place but there needs to be efficient enforcement. When it comes to use of controlled substances like tobacco, there has to be a healthy modicum of respect on the part of users towards the health of non-users, and this is simply not going to be possible as long as effective measures are not enforced.

Gauri Venkitaraman, Lam Tin