The Medical Minute: Second-hand smoking

April 20, 2005

By John Messmer
Penn State Family and Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

Most of us, even the smokers among us, will admit that smoking isn't a good thing. Also, most of us would agree that it is particularly bad for children to smoke. Along the same line of reasoning, most of us would agree that no one should be forced to smoke. So why are all of us, including children, expected to smoke against our wills in work places, restaurants and homes? Second-hand smoke makes smokers of us all.

Annually, second-hand smoke or environmental tobacco smoke (ETS) kills an estimated 35,000 people from heart disease, 3,000 from lung cancer and 1,900 from sudden infant death syndrome while being responsible for almost 10,000 low birth-weight babies, 400,000 episodes of asthma exacerbation in children and 800,000 cases of ear infections. That's on top of the 400,000 deaths in smokers themselves annually in the United States. To get a sense of the number of deaths related to smoking, consider that it is equivalent to three fully loaded Boeing 747s crashing every day.

It's legal for adults age 18 or older to smoke, but smoking at home, in work places and in public areas causes nonsmokers to smoke passively. According to the International Agency for Research on Cancer, ETS increases the risk of lung cancer between 20 and 30 percent for adults. Involuntary smoking is responsible for an approximate 30 percent increase in heart disease and similar effects on respiratory problems. In children, ETS contributes to asthma and reduced lung function. These conclusions are supported by research over several decades and are endorsed by the U.S. Surgeon General and the Public Health Service, the National Institutes of Health and the Environmental Protection Agency.

There had been great resistance to banning smoking in bars and restaurants with predictions of lost jobs and revenue for these establishments. Just the opposite has resulted. Since a smoking ban in restaurants was enacted in New York City, restaurant and bar patronage has increased. Similar results are being seen throughout the nation.

Smokers and the tobacco industry have raised some objections to banning smoking in public places since smoking is legal and is a substantial economic engine for our nation. This ignores the even larger negative effects on health and the cost of health care, amounting to an average of $638 in extra taxes for each Pennsylvania household to cover government expenditures. Businesses lose money from health-related absences and maintenance costs due to smoke damage, not to mention the increased cost of health care for their employees. Smoking-related productivity loss in Pennsylvania is about $4.24 billion and more than $88 billion for the United States. A ban on public smoking results in lower cigarette consumption and could discourage youth from starting to smoke while increasing the incentives for smokers to quit.

You do not have to be exposed to the risks of ETS. Tell restaurant owners and managers you will not return until there is no smoking at their establishment. A nonsmoking section does not protect you because ventilation systems have been shown to be inadequate for eliminating smoke. Encourage your employer to ban smoking indoors.

If you smoke, plan to quit. Sure, it's not easy, but it is possible. Nonsmokers should encourage their smoking friends, relatives and coworkers to quit; but be understanding. Smoking is highly addictive and it is very difficult for someone addicted to nicotine to agree not to smoke.

If we continue to insist on smoke free environments, it will be increasingly difficult for smoking to be found socially acceptable. As more adults quit, fewer children will start and all of us will be healthier.

(Media Contacts)

Last Updated March 19, 2009