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June, 2007:

New Dangers of Secondhand Smoke

By Alice Park –

Researchers have known that secondhand smoke can be just as dangerous for nonsmokers as smoking is for smokers, but now there’s fresh evidence quantifying just how hazardous the after burn from cigarettes can be, and how quickly it affects your body. Scientists at the Oregon Department of Health documented for the first time an hourly buildup of a cancer-causing compound from cigarette smoke in the blood and urine of nonsmokers working in bars and restaurants in the state.

Reporting in the American Journal of Public Health, the researchers found that waitstaff and bartenders working a typical night shift gradually accumulated higher levels of NNK, a carcinogen in cigarette smoke, at the rate of 6% each hour they worked. NNK is known to be involved in inducing lung cancer in both lab rats and smokers.

“We were somewhat surprised by the immediacy of the effect and the fact that we could measure the average hourly increase,” says Michael Stark, the lead author of the study and a principal investigator at the Mulmomah County Health Department in Oregon.

Previous studies conducted in homes where one family member smoked, or in work environments where some employees lit up, had found that nonsmokers in these environments on average increased their risk of developing lung cancer, as well as other health conditions such as heart disease and respiratory ailments, by 20%. And the Surgeon General, in a comprehensive report last year on the health effects of secondhand smoke, determined that there is “no risk-free level of exposure to secondhand smoke.” But until now, it wasn’t clear how quickly the carcinogens became absorbed.

The authors are confident that the increases in NNK in the workers they tested most likely came from their exposure to smoke — the study included a control group of similar subjects in restaurants where no smoking was allowed, and these workers showed no differences in the amount of NNK in their urine before and after their shifts.

The findings only underscore what public health officials have been arguing for decades — that cordoning off smokers in indoor environments or relying on ventilation systems in restaurants and bars is not enough. “There is experimental evidence from studies where you put nonsmokers in a room, blow smoke into the room and measure their artery function, that you see the platelets get sticky, which can cause clots and lead to a heart attack, and the ability of the arteries to dilate decreases very rapidly,” says Dr. Matthew McKenna, director of the office on smoking and public health for the Centers for Disease Control.

All of which could mean more time loitering outside buildings and in alleyways for smokers intent on grabbing a puff. Thirteen states now prohibit smoking in restaurants altogether (most of these include bars as well), and while 11 states still put no restrictions on lighting up, individual cities within those states — such as Austin in Texas, for example — have passed legislation banning smoking in eating establishments and other public areas. Many of these regulations are the direct result of grassroots advocacy efforts; “It’s been a very effective strategy,” says McKenna.” If the discussion moves to a centralized place like the state legislatures, opponents can concentrate their efforts and water down the argument for a ban. But if there are 40 municipalities working on smoking bans at the same time, it’s difficult for opponents to fight so many battles at the same time.”

More states are also passing laws to override a loophole — known as a pre-emption — that prevents cities and local municipalities from passing more restrictive laws than the state. It’s just getting harder to refute the scientific evidence; in a study done in Scotland several months after that nation instituted a ban on smoking in public places, researchers found that following the ban, bar patrons showed stronger lung capacity and reduced levels of inflammation (a red flag for a number of chronic diseases, including heart disease and asthma). “We made it pretty clear that the science on this is pretty irrefutable,” says McKenna. And if smokers have fewer places to smoke, that message may finally get heard.

Raising Cigarette Taxes Reduces Smoking


The cigarette companies have opposed tobacco tax increases by arguing that raising cigarette prices would not reduce adult or youth smoking. But the companies’ internal documents, disclosed in the tobacco lawsuits, show that they know very well that raising cigarette prices is one of the most effective ways to prevent and reduce smoking, especially among kids.

  • Philip Morris: Of all the concerns, there is one – taxation – that alarms us the most. While marketing restrictions and public and passive smoking [restrictions] do depress volume, in our experience taxation depresses it much more severely. Our concern for taxation is, therefore, central to our thinking …
  • Philip Morris: When the tax goes up, industry loses volume and profits as many smokers cut back.
  • RJ Reynolds: If prices were 10% higher, 12-17 incidence [the percentage of kids who smoke] would be 11.9% lower.
  • Philip Morris: It is clear that price has a pronounced effect on the smoking prevalence of teenagers, and that the goals of reducing teenage smoking and balancing the budget would both be served by increasing the Federal excise tax on cigarettes.
  • Philip Morris: Jeffrey Harris of MIT calculated…that the 1982-83 round of price increases caused two million adults to quit smoking and prevented 600,000 teenagers from starting to smoke…We don’t need to have that happen again.
  • Philip Morris: A high cigarette price, more than any other cigarette attribute, has the most dramatic impact on the share of the quitting population…price, not tar level, is the main driving force for quitting.

The cigarette companies have even publicly admitted the effectiveness of tax increases to deter smoking in their required filings with the U.S. Securities and Exchange Commission.

  • Philip Morris: Increases in excise and similar taxes have had an adverse impact on sales of cigarettes. Any future increases, the extent of which cannot be predicted, may result in volume declines for the cigarette industry.
  • Loews/Lorillard Tobacco: Significant increases in federal and state excise taxes on cigarettes . . .have, and are likely to continue to have, an adverse effect on cigarette sales.
  • R.J. Reynolds: Substantial increases in state and federal excise taxes on cigarettes. . . have had and will likely continue to have an adverse effect on cigarette sales.

Economic Research On Cigarette Tax Increases Reducing Smoking.

Numerous economic studies in peer-reviewed journals have documented that cigarette tax or price increases reduce both adult and underage smoking. The general consensus is that every 10 percent increase in the real price of cigarettes reduces overall cigarette consumption by approximately three to five percent, reduces the number of young-adult smokers by 3.5 percent, and reduces the number of kids who smoke by six or seven percent. 8 Research studies have also found that:

  • Among all adults or all youths, cigarette price increases work even more effectively to prevent and reduce smoking among males, Blacks, Hispanics, pregnant women, and lower-income persons.
  • Cigarette price increases not only reduce youth smoking but also reduce the number of kids who smoke marijuana and the amount of marijuana consumed by continuing regular users.
  • Higher taxes on spit tobacco reduce its use, particularly among young males.