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Health Facts
Secondhand smoke causes between 35,000 and 40,000 deaths from heart disease every year. [i] And 3,000 otherwise healthy nonsmokers will die of lung cancer annually because of their exposure to secondhand smoke. [ii]
What is Secondhand Smoke?
- Secondhand smoke is the combination of smoke emitted from the burning ends of a tobacco product (sidestream smoke) and the smoke exhaled from the lungs of tobacco users (mainstream smoke).[iii]
- Secondhand smoke contains over 4000 substances, more than 60 of which are known or suspected to cause cancer.[iv] Some of the deadly substances in secondhand smoke include arsenic, benzene, formaldehyde, and vinyl chloride, and lead.
- The Environmental Protection Agency (EPA) has classified secondhand smoke as a Group A carcinogen, a substance which is known to cause human cancer.[v]
The Effects of Secondhand Smoke
- Nonsmokers exposed to secondhand smoke have been shown to have many of the same tobacco-related diseases as active smokers. Secondhand smoke has been shown to increase nonsmokers’ risk of heart disease, stroke, and cancer.[vi]
- Secondhand smoke can cause many short-term effects, such as coughing and nasal and eye irritation.
Who Is Exposed to Secondhand Smoke?
- Exposure of the general U.S. population to secondhand smoke has declined dramatically since 1988-1991. However, 60 percent of people living in the United States still have biological evidence of secondhand smoke exposure.[vii]
- Secondhand smoke has become an occupational hazard for many workers, including casino, restaurant, bar, and hotel employees. Although over three fourths of white collar workers are covered by smoke-free policies, just 43% of the country’s 6.6 million food preparation and service occupations workers benefit from the same level of protection.[viii]
- Younger workers (15-19 and 20-24 years) were least likely to work under a smoke-free policy.[ix]
- Fifteen million kids, or nearly 22% of all children and adolescents, were exposed to secondhand smoke in the home during 1996.[x]
- The CDC has found higher levels of secondhand smoke exposure among African Americans than for any other race or ethnic subgroup.[xi]
Hospitality Workers are at Higher Risk for Secondhand Smoke Exposure
- Food service workers have a 50 percent greater risk than the general public of dying from lung cancer, in part because of their continuous exposure to secondhand smoke in the workplace.[xii]
- Waiters and waitresses have the highest levels of secondhand smoke exposure.[xiii]
- Levels of secondhand smoke in restaurants are 1.6 to 2 times higher than levels measured at office worksites and 1.5 times higher than levels in homes with at least one smoker.[xiv]
- Fewer than 15 percent of bartenders nationwide are protected from secondhand smoke exposure.[xv]
- Levels of secondhand smoke in bars are 3.9 to 6.1 times higher than levels measured at office worksites and up to 4.5 times higher than levels in homes with at least one smoker.[xvi]
- 74 percent of bartenders surveyed in San Francisco, California in 1997 reported respiratory symptoms (e.g., wheezing, cough, etc.) and 77 percent reported sensory irritation symptoms (e.g. red, teary, or irritated eyes, runny nose, sneezing, sore or scratchy throat, etc.).[xvii]
- Casino workers are at higher risk for secondhand smoke related illness.
- Casino workers who staffed non-smoking tables did not have lower levels of secondhand smoke exposure than workers who staffed smoking tables.[xviii]
- NIOSH found occupational exposure to secondhand smoke increased workers’ risk of lung cancer and other diseases. The agency recommended that workers be protected from involuntary exposure to secondhand smoke.
- Tobacco smoke is a complex mixture. When compared to mainstream smoke, sidestream smoke emits higher amounts of several toxic chemicals. For each cigarette smoked, a nonsmoking employee inhales:
- as much benzene as one who has smoked six cigarettes;
- as much 4-aminobiphenyl as one who has smoked 17 cigarettes; and
- as much N-nitrosodimethylamine as one who has smoked 75 cigarettes.[xix]
- The evidence shows that implementing smoke-free policies has immediate benefits on restaurant and bar workers’ health.
[i]Steenland, K. (1992). Passive Smoking and the Risk of Heart Disease. Journal of the American Medical Association 267(1): 94-99.
[ii] U.S. Environmental Protection Agency (EPA) (1992). Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, D.C.: EPA.
[iii] U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control (CDC) (1986). The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. Washington D.C.: Government Printing Office (GPO).
[vi] National Cancer Institute (NCI) (1999). Health Effects of Exposure to Environmental Tobacco Smoke: The Report of the California Environmental Protection Agency. Smoking and Tobacco Control Monograph 10. Bethesda, MD: NCI.
[vii] CDC (2003). Second National Report on Human Exposure to Environmental Chemicals: Tobacco Smoke. Atlanta, GA: U.S. Department of Health and Human Services, CDC, National Center for Environmental Health. NCEH Pub No. 03-0022.
[viii] Shopland, D.R., Anderson, C.M., Burns, D.M., and Gerlach, K.K. (2004). Disparities in smoke-free workplaces among food service workers. Journal of Occupational and Environmental Medicine 46(4): 347-356.
[ix]Gerlach, KK., Shopland, D.R., Hartman, A.M., Gibson, J.T., and Pechacek, T.F. (1997). Worplace Smoking Policies in the United States: Results from a National Survey of more than 100,000 Workers. Tobacco Control 6:199-206.
[x] CDC (1997). State-Specific Prevalence of Cigarette Smoking Among Adults, and Children’s and Adolescents Exposure to Environmental Tobacco Smoke—United States, 1996. MMWR 46(40):1038-1043.
[xi] CDC. National Center for Environmental Health (2001). First National Report on Report on Exposure to Environmental Chemicals. Washington, D.C.: Centers for Disease Control and Prevention.
[xii] Siegel, Michael (1993). Involuntary Smoking in the Restaurant Workplace: A Review of Employee Exposure and Health Effects. JAMA 270(4): 490-493.
[xiii] Wortley, P.M., Caraballo, R.S., Pederson, L.L., and Pechacek, T.F. (2002). Exposure to Secondhand Smoke in the Workplace: Serum Cotinine by Occupation. JOEM 44(6): 503-509.
[xvii] Eisner, M.D., Smith, A.K., and Blanc, P.D. (1998). Bartenders’ Respiratory Health After Establishment of Smoke-Free Bars and Taverns. JAMA 280(22): 1909-1914.
[xix] Hammond, K.S., Sorensen, G., Youngstrom, R., and Ockene, J.K. (1995). Occupational Exposure to Environmental Tobacco Smoke. JAMA 274(12): 956-960.
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