Why are teens smoking and vaping?

Everyone agrees how important it is that youths should not be smoking or vaping. 

Even tobacco companies have said so publicly for decades, although internal tobacco company documents clearly show that they:

- targeted teenagers with flavors,[1] 

- referred to 14-to-18-year-olds as “young adult smokers,” studied teen smoking patterns (differentiating between “presmokers”, “learners” and “confirmed smokers”), admitted that “the base of our business is the high school student,”[2] 

- recognized that “the renewal of the market stems almost entirely from 18-year-old smokers”[3] and that “today’s teenager is tomorrow’s potential regular customer,”[4] and 

- concluded that “the ability to attract new smokers and develop them into a young adult franchise is key to brand development.”[5] 

In order to survive and prosper over the long term, tobacco companies have seen the need to capture the youth market, developing new products and brands that appeal to youths, because “younger adult smokers are the only source of replacement smokers... If younger adults turn away from smoking, the industry must decline, just as a population which does not give birth will eventually dwindle."[6] 

References:

(1) Marketing Innovations. (1972). Youth cigarette - New concepts [memo to Brown & Williamson]. Bates No. 170042014 

(2) Achey TL. (1978). Memo from Lorillard sales manager Achey to CEO Curtis Judge about the "fantastic success" of Newport, August 30, 1978. Bates No. TINY0003062 

(3) R.J. Reynolds. (1984). Young adult smokers: Strategies and opportunities [report]. Bates No. 501928462-8550 

(4) Johnston ME. (1981). Young smokers prevalence, trends, implications, and related demographic trends [Philip Morris market research report, 31 March 1981]. Bates No. 1000390803 

(5) Philip Morris International. (1999). Worldwide Marlboro monitor: Five year trends, 1988-1992. Bates No. 2044895379- 484 

(6) R.J. Reynolds. (1984). Young adult smokers: Strategies and opportunities [report]. Bates No. 501928462-8550

Smoke-free air is aerosol-free. Don't be fooled.

Tobacco smoke is a chemical aerosol, composed of gaseous and particulate matter. It is also toxic and carcinogenic, and up to 70 carcinogens have been identified among its thousands of chemicals.

Electronic smoking devices (ESD) such as electronic nicotine delivery systems (ENDS) and heated tobacco products (HTP) also emit similar chemical aerosols. They do not emit simple water vapour.

In fact, ESDs emit many of the same toxic chemicals in tobacco smoke (as well as new ones); albeit studies seem to show a lesser concentration of these toxicants and carcinogens.

ESD proponents, including tobacco companies and their vociferous lap dogs, publicly claim that ESD use is less harmful (even "95% less harmful") than cigarette smoking, that cigarette smokers can "quit" smoking by switching to ESDs, and that smokers have a right to access these "safer" alternatives to cigarettes.

The "95% less harmful" factoid has been debunked for years, but even if it were true, is there such a thing as a "less harmful" poison or cancer? Is it okay to jump from the 5th floor rather than the 100th floor of a building?

The truth is that none of the manufacturers of these ESDs can or will claim that their products are safe or harmless, and so far, none of them have registered their products as smoking cessation devices in any country in the world. Doesn't that make you wonder why?

In its application to the US FDA, Philip Morris even gave an "important warning" - "It has not been demostrated that switching to the IQOS system reduces the risk of developing tobacco-related diseases compared to smoking cigarettes."

Source: FDA does not rule that IQOS reduces tobacco-related harm, yet PMI still claims victory
https://exposetobacco.org/wp-content/uploads/STP054_FDA_IQOS_Brief_v3.pdf

So remember:

Read more about Electronic Smoking Devices and Secondhand Aerosol here.

By law, NAIA should be 100% smoke-free indoors (part 1)

Last week, Sen. Pia Cayetano complained about the poor condition of NAIA, particularly focusing on the filthy air caused by allowing smoking indoors.

In April 2012, I wrote to the MIAA general manager on this very issue. I'll share the reply I got from MIAA, as well as the CSC legal opinion, in my next blog posts.

Part 2
Part 3

-------------------

Date: Mon, Apr 9, 2012 at 9:50 PM

Subject: smoking rooms at NAIA

To: gmo@miaa.gov.ph, sagm@miaa.gov.ph, aod@miaa.gov.ph, pao@miaa.gov.ph, media@miaa.gov.ph,md@miaa.gov.ph, rfd@miaa.gov.ph

Cc: mmou@webmail.csc.gov.ph, <smoke_free_bureaucracy@yahoo.com>

MGen. Jose Angel A. Honrado, AFP (Ret)

General Manager

MIAA

Dear Sir,

I am writing to you about my recent experience flying through NAIA, wherein I and hundreds of other departing passengers were involuntarily subjected to the harmful fumes of tobacco smoke coming from the smoking room at the departure area. Unfortunately, this harm to health of all passengers, as well as airport and airline staff, is occurring on a daily basis.

The scientific evidence on this matter spans decades and is very clear in its conclusions: there is no safe level of exposure to tobacco smoke. This is widely recognized by the World Health Organization, the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), International Agency for Research on Cancer (IARC), as well as the 174 Parties (including the Philippines) to the Framework Convention on Tobacco Control (FCTC).  The only way to prevent health harms is through effective public protection policies that prevent human exposure to tobacco smoke, that is by prohibiting smoking in all indoor public places and workplaces.

Given that the airport, as well as the MIAA, are government premises and that MIAA staff are government employees, the MIAA is also duty-bound to implement the Civil Service  Commission (CSC) Memorandum Circular no. 17, s. 2009, which prohibits smoking in all government buildings and promotes a 100% smoke-free environment in government premises, in order to protect both the government workforce and the public that they serve.  I am sure the CSC can assist you in preparing the proper signages to implement this policy. 

I therefore appeal to you to remove the smoking lounges from the various NAIA terminal buildings and designate only OUTDOOR smoking areas, in locations where the smoke will not be able to affect the airport staff and the public that uses the airport facilities.  For your information, there are more than 250 airports in the United States that are 100% smoke-free, including some of the biggest and busiest ones. There are also many others in Canada, South America, Australia, and Europe. Even Beijing Capital International Airport closed its smoking lounges and became 100% smoke-free in 2011. Other Asian countries are also planning to follow suit because this is one way to encourage tourism, by providing clean and healthy airport environments.

Thank you for providing a healthy environment for all and for fulfilling your duty under CSC MC 17, s. 2009.

Sincerely,

Dr. Yul Dorotheo

Indeed, if tobacco is such a good product, why don't tobacco executives use it themselves?

Nassim Taleb: "Never buy a product that the owner of the company that makes it doesn't use, or, in the case of, say, medication, wouldn't contingently use." 

(from: http://www.businessinsider.com/nassim-talebs-musings-on-facebook-2013-7#ixzz2ZFlix7xX)

Got to agree with the eccentric author of "The Black Swan" on this one.  Indeed, why don't tobacco executives use their products, and why don't they want their children to use them? Here's the response of tobacco executives from R.J. Reynolds when asked by Dave Goerlitz, then a Winston cigarette ad model, about why none of them smoked:

"We don't smoke that sh*t. We just sell it. We reserve the right to smoke for the young, the poor, the black and the stupid." - as quoted in The Times of London, 02 August 1992.

Misinformed opinions about tobacco taxes and smuggling

This is my response to an article by Neal Cruz (High cigarette taxes will encourage smuggling, Philippine Daily Inquirer, September 20, 2011)

Ducky Paredes also makes a similarly misinformed opinion in his article (Learning from Singapore, Malaya, May 24, 2011)

Strong international evidence and experience exists to support tobacco tax increases, because they are effective not only in raising government revenues but also in reducing consumption of a harmful product, especially among vulnerable sectors such as the young and the poor. This is why parties to the WHO Framework Convention on Tobacco Control (FCTC), the Philippines among them, are obligated to implement tax policies and, where appropriate, price policies, on tobacco products so as to contribute to national health objectives aimed at reducing tobacco consumption.

The tobacco industry often argues that smuggling will increase with any tax increase. The international evidence however shows that tobacco smuggling is generally higher in low-income countries where taxes and prices are low, while smuggling is low in high-income countries where tobacco taxes and prices are high. This correlates well with the levels of anti-smuggling enforcement and corruption in each country. While a price differential across borders provides an incentive for smuggling, it is the laxity of anti-smuggling measures and the propensity for corruption that facilitates the actual smuggling. Conversely, if there is very tough anti-smuggling enforcement with stiff penalties, this is a strong disincentive that discourages smuggling.

"Long and porous borders" are also cited by the tobacco industry as an argument against raising taxes because it is "impossible" to defend these borders against smugglers.  Aside from being an obvious insult to our customs and border patrol officials, this argument also rings hollow. There are many countries with long and porous borders that have strong anti-smuggling measures in place, and which have high tobacco taxes and prices, such as the UK, Japan, and Australia.

Singapore

Neal Cruz is mistaken regarding smoking prevalence in Singapore, which he says was unchanged from 2001 to 2007. Based on a 2010 ERC report (an industry-oriented publication), per capita cigarette consumption dropped steadily from just under 1,200 sticks in 1990 to under 400 sticks in 2006. This is in consonance with the declining adult smoking prevalence rate which dropped from 18.3% in 1992 to 15.2% in 1998 to 12.6% in 2004, and which correlates well with the regular tax increases during the same period, averaging a 4% price increase per year. Additionally, Singapore has banned all tobacco advertising, promotion, and sponsorship and promoted smoke-free public places since the 1970s and also began implementing pictorial health warnings in 2004.  

Contrary to what the industry is claiming, Singapore has been able to successfully curb cigarette smuggling and keep its incidence low. In 2007 and 2008, according to a Singapore Customs Media Release in 2008, around 4.4% of cigarettes were smuggled, but this was significantly reduced in 2009 to around 2.37% (Singapore Customs Enforcement Data 2010). This can be attributed to Singapore’s integrated and multi-pronged-government tobacco control strategy that includes not only demand reduction measures (less people smoking), but also supply reduction measures such as strengthening customs enforcement, which subsequently saw an increased number of arrests and seizures for cigarette smuggling.  It is this increased anti-smuggling effort that has resulted in increased seizure volumes, not that there has been an increase in smuggling.

Unfortunately, there has been no tobacco tax increase in Singapore since 2005, and given Singapore's economic growth, this has made cigarettes more affordable and contributed to the slowly increasing per capita consumption seen from 2006 to 2009 (also ERC data) and the increase in adult smoking prevalence from 12.6% in 2004 to 13.6% in 2007.  Tobacco industry puppets attribute this to cheap smuggled cigarettes, but the truth is that it is primarily driven by increasing affordability of legal cigarettes due to the stagnation of tobacco excise tax rates since 2005.

Malaysia

According to the ERC 2010 data, contrary to what Neal Cruz claims (that smoking incidence was virtually unchanged), per capita cigarette consumption also declined steadily in Malaysia from around 1,100 sticks in 1990 to under 700 sticks in 2009.  It was the repeated tax increases over the years that drove this decline, as well as a ban on all tobacco advertising, promotion, and sponsorship in the past decade and the government’s “Tak Nak” media campaign. In 2009, Malaysia also started requiring pictorial health warnings on all cigarette packs.

The Confederation of Malaysian Tobacco Manufacturers (CMTM), which is actually three transnational tobacco companies (British American Tobacco, Philip Morris International, and Japan Tobacco International) that control 97% of the local market, is the one claiming that smuggling accounts for close to 40% of the local market. Given that 97% of the market is controlled by these 3 large companies, primarily BAT Malaysia, and given that most of the smuggled brands are reported by them as not being their company brands, it seems unrealistic to believe that 4 out of 10 cigarette packs sold in Malaysia are illegal.

New York City

Over the past decade, New York City has prohibited smoking in virtually all indoor workplaces, including bars and restaurants; raised excise taxes; and launched a number of hard-hitting anti-tobacco media campaigns to significantly raise public awareness.  The results? Prior to 2002, the prevalence of smoking among adults had remained steady at about 22% for a decade. But between 2002 and 2010, that number dropped to 14%, resulting in more than 400,000 fewer adult smokers in New York City. Furthermore, between 2001 and 2009, smoking prevalence among students aged 14-18 years dropped from 18% to 8%.  Contrary to the doomsayers’ predictions about the economic calamity that would come with strong tobacco policies, New York City’s economy has been unaffected. And with consumer demand being that low, how does that fit with the tobacco industry’s claims that cigarette smuggling is rising in leaps and bounds?

Australia

It is surprising that Neal Cruz recommends Australia as a best model for the Philippines to follow, because, similar to claims in Malaysia, the tobacco industry (led by BAT Australia) is claiming that 1 out of 6 cigarettes sold there is illicit.  Can any reasonable person imagine this happening?  If it is so rampant, this would mean that 1 out of six smokers knows where to obtain these illegal cigarettes, and wouldn’t the government authorities be aware of this as well?

The facts around tobacco tax increases being pegged to the CPI are also not exactly as they have been presented.  The truth is that prior to a 25% tax increase in 2010, Australia had not raised tobacco excise in real terms since 1999.  The tax increases in nominal terms that resulted from tax rates being in line with the CPI may have increased government revenues, but they certainly did not produce the decline in smoking rates that were expected. There were still around 15,000 Australians dying each year from tobacco-related diseases.  Hence, the government raised taxes by 25% in 2010, at the same time announcing that there would also be significant tax increases in 2011 and 2012. In the same effort, the Australian government also announced that it would require the world’s first plain packaging of tobacco products beginning in 2012.

Finally

The Philippines does need an equivalent of the Australian excise tax system, which is indexed to inflation but also significantly raises prices so as to effectively discourage consumption of a harmful product that causes so much preventable disease, disability, and death, as well as suffering, among Filipinos.

For a discussion of cigarette affordability and the needed tobacco tax reforms needed to correct the flaws current excise system, please read the policy paper here: http://seatca.org/dmdocuments/SITT%20Philippines%20Affordability%20Policy%20Paper_Final.pdf

A more comprehensive discussion of these tax reforms can be found in the monograph “Taxing Health Risks” by the UP College of Law and HealthJustice (http://seatca.org/dmdocuments/Taxing%20Health%20Risks%20Philippines%202010.pdf)

The key message here is to keep raising taxes and prices so that consumption starts to decline and so that the government revenues from such tax increases can be used for tobacco control (including smuggling control), health promotion, universal health care, social development, and a host of other socially beneficial programs.

And of course, don’t believe the tobacco industry’s misrepresentation of the facts.

Related articles

• Roxon urges UN to fight big tobacco (news.theage.com.au)

MMDA is mandated by law to protect public health

Thinking aloud: (my response to someone's blog article, which is copied below)

On top of the annual 5.4 million killed globally by tobacco use, there are at least 600,000 people who die from exposure to second-hand smoke (SHS) each year.

In addition to RA9211, which is the only law being cited by the Philippine Tobacco Institute, the tobacco industry's lobbying arm, the Philippines also has at least 2 other laws that cover smoking:
a. the Clean Air Act, which prohibits smoking in public places, and
b. the Framework Convention on Tobacco Control (FCTC), an international public health treaty to which the Philippines and 173 other countries are Parties.

Based on irrefutable scientific evidence, the World Health Organization recommends that because there is no safe level of exposure to tobacco smoke, only 100% smokefree public places can effectively protect people from such harmful exposure.  This is also the core recommendation contained in the FCTC Article 8 Guidelines to help countries implement their treaty obligations.

For more information on second-hand smoke:
http://dryul.blogspot.com/2010/08/what-is-second-hand-smoke-shs.html

There is also clear scientific evidence that shows how secondhand tobacco smoke, especially indoors, is more harmful and more concentrated than vehicular smoke emissions.

Thus there is very strong legal and scientific basis for both MMDA and the LGUs to develop, implement, and enforce smoking restrictions that will protect Philippine public health.  In fact, the national government also has the same legal and scientific basis to correct the weaknesses and inconsistencies in RA9211 (loopholes created by the tobacco industry) because the FCTC (based on scientific evidence and international best practice) was ratified by the Philippines after RA9211 was signed into law.

It's actually quite terrible that some congressmen give public health the lowest priority in their legislative agenda.  They seem blind to the obvious fact that health is a cornerstone of social and economic development of our people and our country. Of course, some of them are in it more for the power and money rather than to serve the Filipino people.

---------------
Smoking Ban: Boon or Bane?
An article by kinky
http://otra-cosa.com/httpdocs/?p=3171#comment-107

These past few months, May, to be exact; the court has ordered the Metropolitan Manila Development Authority (MMDA) to implement the non smoking ban in Metro Manila, all of its cities and municipalities included.

It is to prohibit smoking of cigarettes in public places. From bus terminals, waiting sheds, schools, hospitals, recreational places and inside public utility vehicles, as they are putting up a campaign to protect Filipinos from secondhand smoke.

Smokers caught violating the public smoking ban will be fined PHP500 for the first offense, PHP 1000 for the second offense and PHP5000 for the succeeding violations. If a person is not able to afford the fine, they are required to serve 8 hours of community service. Frequent violators can also be detained.

The MMDA, however, announced that people can still smoke in designated areas so as not incur charges. Thinking about it, I being a smoker myself make me wonder if it would benefit me. Maybe, but can you really stop these major companies like Marlboro, Winston, Salem, etc. to stop their operations? Being part of the major investors in our country to stop their production? I don’t think so. A lot of people in the Philippines smoke, even our own President. It’s hard to stop this kind of industry.

There are a lot of loose ends on this new ordinance. They are issuing the MMDA to enforce the ban. The MMDA is placed under a “no line agency” and it exists by itself according to Section 29 of this new non smoking law. So technically, MMDA does not have the right to enforce the ordinance. If the Congress wanted to have MMDA implement the ban, they should have included MMDA in the list of implementing agencies in the first place. Also, the Philippine Tobacco Institute (PTI) is arguing that having the major and secondary roads included in this non smoking law is not included in the list of prohibited places according in the RA9211.

Because of these and a few more others, the court issued a temporary restraining order against the smoking ban.

I mean, this new law may benefit almost everyone, definitely not the smokers. But this is already out in the open and people tend to put more effort here than the other factors that have been going on longer than this one. Smoke belching public buses, jeeps and cars, for instance. Isn’t that more hazardous than cigarette smoke? The black smog that those public utility vehicles have been emitting, isn’t that more dangerous than cigarette smoke?

I strongly believe that being in the streets of Manila for 5 minutes does more harm than being a passive smoker for 10 years.

MMDA and the police force should first remove all those smoke belching jeeps, buses, trucks and the likes off the streets first than those cigarette smokers. That’s the only time that Metro Manila will be clean. They should remove the real threats first.

I hope the courts would be able to fix the loopholes in their smoking law. And as a Filipino, I support it even if I am a smoker. But the current state of this law is still shady, so fix this, as it affects everyone. The smokers in particular.

Making Metro Manila Smoke-Free: Quit Smoking and Live Longer | The Manila Bulletin Newspaper Online

September 5, 2011, 12:58am

MANILA, Philippines — The smoking ban in Metro Manila continues as agencies and individuals have expressed support for the campaign. As part of its “Kalusugang Pangkalahatan’’ (Health for All) program, the Department of Health (DoH) is supporting the move of the Metro Manila Development Authority (MMDA) to push the campaign against smoking, because of the harmful effects it causes not only to smokers but also to the public through second-hand smoke.

Tobacco smoke contains three dangerous chemicals: Tar, nicotine, and carbon monoxide, placing passive smoker at high risk. The major diseases caused by smoking include cardiovascular disease, cancer, and chronic obstructive pulmonary diseases. Smoking reduces life expectancy by seven to eight years.

Children are prone to lung ailments such as asthma, bronchitis and pneumonia. Infants under two years old are prone to respiratory infections. There is also the possibility of inhibited physical growth and brain development.

MMDA is pursuing the smoking ban in areas covered by Republic Act (RA) 9211 the Tobacco Regulation Act of 2003, in Metro Manila, citing its mandate under RA 7924, which created the agency, “to pursue more health-related advocacies to promote public health, safety and sanitation, urban protection, and pollution control.’’ MMDA is seeking to transform the metropolis into a smoke-free community.

Section 5 of RA 9211 bans smoking in public places such as centers of youth activity as schools and recreational facilities, elevators and stairwells, gas stations and storage areas for flammable liquids, gas or combustible materials, premises of public and private hospitals, medical, dental, and optical clinics and health centers, nursing homes, dispensaries and laboratories, airport and ship terminals, train and bus stations, restaurants and conference halls.

The main consideration in the campaign to ban smoking in public places is the health and wellness of the public. Its success in the long term hinges on the support and cooperation of government and non-government groups, the private sector, communities, and individuals. Quit smoking and live longer!

Youth are targets of tobacco companies

This is copied from

http://www.preda.org/main/archives/2010/r10081801.html

Youth Are Prime Target of Killer Cigarettes  

(republishing, copying, no restrictions)
By: Father Shay Cullen

Cigarette Smoking can cause cancer in the neck.

It’s when the frightening desperate gasping for breath fills the house and the fifty-five year Pedro Galmanan, father of five, struggles to suck oxygen into his lungs to stay alive and his children realize the terrible effects cigarette smoking has on their father.

His addiction to cigarettes cost him his job, drove the family into poverty and his withdrawal symptoms were an agony to witness. They now watch their father slowly die wheezing as the emphysema consumes his life.

Tobacco is a killer, a poison of mind and body, its addicting and destructive of families. Besides causing cancer, especially lung cancer, and other diseases such as cardiovascular, pulmonary, metabolic diseases, the smoke causes heath problems to bystanders too.

In the Philippines, it is estimated that cigarette smoking kills as many as 250 people a day, 90,000 a year. The greatest evil is that tobacco companies are targeting the youth and succeeding in addicting them in their thousands every year.

The tobacco industry must recruit new young smokers and addict them for life to continue its profit making business since it is aggressively killing off its customer base with its poison product. The dead have to be replaced with the living. In Indonesia alone cigarette smoking kills as many as 400,000 people a year and costs the nation billions of dollars in health costs.

The Philippine tobacco industry, whose interests are represented by the Philippine Tobacco Institute (PTI) are a powerful and influential lobbying body. Members and supporters include the Philippines’ biggest tobacco firm, Lucio Tan’s Philip Morris-Fortune Tobacco Corporation, and other corporations like the Anglo-American Tobacco Corporation, La Suerte Cigar and Cigarette Manufacturing Inc., and Mighty Tobacco Corporation.

As the name suggests they have mighty influence in the Philippine congress and allegedly donate to politicians. Influential lobbyists allegedly manipulated the congress to water down the stronger provisions of the proposed anti-smoking law (RA 9211 passed in 2003), with words that they can now use to their advantage to prevent stronger health warnings on cigarette packs such as graphic pictures.

The newly appointed Department of Health (DOH) Secretary Enrique T. Ona has vowed to implement the departments order (AO 2010-13) issued by the previous health secretary Esperanza Cabral to have the tobacco companies print graphic images on their cigarette packs as health warnings as they do on there export packs as required by Singapore and Thai law.

The DOH order was immediately and aggressively opposed by the tobacco lobby led by the president of the Philippine Tobacco Institute Rodolfo Salanga. He warned Secretary Cabral that such images would be illegal under RA 9211. But he has been shown to be incorrect since the present law only forbids additional text, not pictures, to be added to the pack.

The graphic images have the most powerful deterrent effect on youth. It is one of the recommendations of the World Health Organization’s framework Convention on Tobacco Control (FCTC) which demands the 168 signatories, like the Philippines, to “implement large, rotating health warnings on all tobacco packaging and labeling”. Already 38 countries have implemented the picture-based warnings and the 27 member European Union has recommended each member to implement it.

Fortune Tobacco Company headed by the tycoon Lucio Tan won a preliminary injunction against the health department to stop the implementation of the order that was issued May 24, 2010 to place the picture-warnings on the packs. Judge Reyes of Marikina ruled last July 1, in favor of the company.

The power and influence for the tobacco industry worldwide is well known and actively opposes every restriction that will save people from smoking related ill-health. These tactics are so well known that the WHO convention against smoking had this to say to nations who are party to the convention: “In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.” WHO Framework Convention on Tobacco Control Article 5.3

There is a battle out there in the world, in every country where cigarettes are sold and millions of victims are facing the possibility of a very painful and agonizing death from smoking related diseases. We have to do all we can to stop the promotion and sale of killer cigarettes.

email: preda @ info . com . ph , www.preda.org

What is Second-hand Smoke (SHS)?

Image via Wikipedia

Tobacco smoke has been classified as a human carcinogen.

It contains more than 4000 chemicals, including more than 200 which are poisonous and at least 69 which are cancer-causing, as well as gases like carbon monoxide, which affects the body’s ability to deliver oxygen to the heart and brain.[i]^,[ii]^,[iii] The long list of carcinogenic and toxic substances that have been identified in tobacco smoke includes: tobacco-specific N-nitrosamines (TSNAs), ammonia (added to cigarettes to enhance the absorption of nicotine), benzene, formaldehyde, acetone, arsenic, butane, hydrogen cyanide (used as a genocidal agent during World War II), lead, mercury, methane, naphthalene, and even Dichloro-Diphenyl-Trichloroethane (DDT) and at least 3 other pesticides known to be unsafe and carcinogenic for humans.

Second-hand smoke (SHS), or environmental tobacco smoke, is a complex mixture of thousands of gases and fine particles emitted from the burning end of a cigarette or from other tobacco products usually in combination with the smoke exhaled by the smoker.[iv] It can linger for more than 2 hours, and may be invisible and odorless.[v]^{, [vi]}

Harms of second-hand smoke

Second-hand smoke is harmful. Inhaling second-hand smoke is just as dangerous as actually smoking. The non-smoker who inhales the smoke from a smoker’s cigarette also suffers as much harm to his body as the smoker does.[vii]^{, [viii]}

There is no safe level of exposure to second-hand smoke.^[viii], [ix]

Second-hand smoke is a significant health risk for all those exposed to it^{[vii], [viii],} [ix] -- from persons near the smoker, to the unborn child of a pregnant smoker, to someone in a room where particles from second-hand smoke linger long after the smoker has left. Even pets of smokers are affected.[ix]^{, [x], [xi]}

Consider these facts:

• Nicotine by-products have been found in non-smokers, even babies, exposed to second-hand smoke. [xii]^{, [xiii]}
• Exposure of merely 30 minutes to second-hand smoke makes blood platelets stick together and damages blood vessels, and has the same effect as a pack-a-day smoker. ^{[xiv], [xv], [xvi], [xvii]}
• Exposure of slightly more than 2 hours causes higher “bad” cholesterol levels, and puts the non-smoker at greater risk for arrhythmia (irregular heartbeat).^{[xvi], [xvii],} [xviii]

Immediate effects of exposure to second-hand smoke are coughing or wheezing, phlegm, and shortness of breath, perhaps dizziness and nausea. Long term effects are more serious. [iv]

In adults, second-hand smoke causes chronic heart disease and heart attacks, lung and breast cancer, and respiratory disease. Non-smokers who live with smokers are more likely to develop lung cancer and heart disease. Because second-hand smoke contains 20 known mammary carcinogens, non-smoking women who live with smokers are at greater risk of developing breast cancer. [iii] It can trigger and exacerbate asthma attacks, and even induce asthma in healthy individuals.^[viii], [ix]

Maternal smoking during pregnancy causes fetal growth impairment which leads to low birth weight, as well as premature delivery, and in some cases, even miscarriage. Babies born to mothers who smoke are often smaller and more likely to develop respiratory ailments than those whose mothers did not smoke, or were not exposed to second-hand smoke, during pregnancy.^{[viii], [ix], [xviii]}

Babies and children of smokers, who are thus exposed to second-hand smoke, suffer from sudden infant death syndrome, lower respiratory disease like asthma, pneumonia, bronchitis, and middle ear disease, which can lead to hearing impairment if left untreated. They also suffer from impaired lung growth function, which puts them at risk for respiratory illness as they grow older.^{[viii], [ix],} [xix]

Children of smokers have more learning difficulties and behavioral problems, like hyperactivity and decreased attention spans, than children of non-smokers.[xix]

In addition to the harm caused to health, second-hand smoke also has a negative economic impact on individuals, families, and society in general through medical and hospitalization expenses, loss of personal income, and production losses due to employee sickness and absences from work.[ii]^,[iii]

--------------------------

[i] Mackay J, Eriksen M, and Shafey O.  The Tobacco Atlas, 2^nd ed. American Cancer Society, 2006.

[ii] Muller T. Global Voices for a Smokefree World: Movement Towards a Smokefree Future, Global Smokefree Partnership, 2007.

[iii] World Health Organization. Protection From Exposure to Second-hand Smoke. Policy Recommendations. Geneva, 2007. (http://www.who.int/tobacco/resources/publications/wntd/2007/who_protection_exposure_final_25June2007.pdf, accessed 24 September 2007).

[iv] Pan American Health Organization. Factsheet: How Second-hand Smoke Harms and Kills Non-smokers (http://www.paho.org/English/AD/SDE/RA/wntd-factsheet2.pdf, accessed 24 September 2007)

[v] WHO Framework Convention on Tobacco Control – Conference of Parties. Article 8: Guidelines on protection from exposure to tobacco smoke. Geneva, 2007.

(http://www.who.int/gb/fctc/PDF/cop2/FCTC_COP2_17P-en.pdf, accessed 24 September 2007)

[vi] UK National Health Service. Secondhand Smoke. Go Smokefree website.

(http://www.gosmokefree.co.uk/secondhandsmoke/, accessed 25 September 2007)

[vii] UK National Health Service. How Your Secondhand Smoke Affects Others. Go Smokefree website. (http://www.gosmokefree.co.uk/secondhandsmoke/howyoursmokeaffectsothers/, accessed 25 September 2007)

[viii] US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Secondhand Smoke What It Means to You. Atlanta, Georgia: 2006. (http://www.surgeongeneral.gov/library/secondhandsmoke/secondhandsmoke.pdf, accessed 25 September 2007)

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