task51

1

Secondhand Smoking And Health Implications

Secondhand Smoking and Health Implications

BY Soumith Chunchu

EBM 502 (Research Methods)

Stratford University

2


Table of Contents

Abstract…………………………………………………………………………………………………………….3

Introduction………………………………………………………………………………………………………4

Background……………………………………………………………………………………………………….5

Problem Statement…………………………………………………………………………………………..5

Purpose Statement……………………………………………………………………………………………6

Research Questions…………………………………………………………………………………………..6

Literature Review………………………………………………………………………………………………7

Research Instruments……………………………………………………………………………………….16

Findings…………………………………………………………………………………………………………….16

Conclusion…………………………………………………………………………………………………………17

Limitations of Study…………………………………………………………………………………………..17

References…………………………………………………………………………………………………………18

3


Abstract

Secondhand smoking (SHS) is caused by the smoke released from burning end of cigarette and

Exhaled by active smoker .The chemicals and toxic gases present in cigarette smoke are

Released into air causes several lung diseases to the people who inhale released smoke.

Tobacco smoking contains fifty of cancer-causing compounds that are known to cause cancer.

Cigarette smoking a toxic of more than 7 thousand chemical compounds .Secondhand smokers

Exposes to severe diseases more than the active smokers because active smoker has a filter to

The cigarette, which filters the chemicals .secondhand smokers inhale the smoke released from

The burning end of the cigarette directly .Smoking causes obstruction of lung airflow that

Interferes with normal breathing and is not completely reversible. Annually 53,800 people are

dying from the exposure of secondhand smoke. Among the total deaths caused by SHS 48,500

are caused by heart diseases, 3,000 are causing by lung cancer, 2300 are causing by SIDS (EPA

1973).Absence of knowledge about SHS in people is the main cause of deaths caused due to

secondhand smoking .Because people In rural areas are most affected victims of SHS .People

can be insulated from Secondhand Smoking by prohibiting smoking in public and open areas

.Government should bring awareness among people through advertising and educating them

about the effects of secondhand smoking.

4


Introduction

Smoking is very harmful to health .It causes several lung diseases like lung cancer and chronic

Obstructive pulmonary disease .Smoking causes obstruction of lung airflow that interferes with

Normal breathing and is not fully reversible .cigarette smoking a toxic of more than 7 thousand

Chemical compounds .The smoke released from the burning end of the cigarette and exhaled

By the smoker is released into air and is breathed by the other people who are near the smoker

, These people are the secondhand smokers and this process is called as secondhand smoking

.Tobacco contains thousands of harmful chemicals which are released into the atmosphere

Through smoking .Smoking can easily kill people when breathed in large amounts because it

Contains chemicals includes benzene, carbon monoxide and hydrogen cyanide. Tobacco

Smoking contains fifty of Carcinogens compounds that are known to cause cancer .The topic of

Active smoking was first mentioned in surgeon’s general report on the health consequences of

Active smoking (USDHEW 1964).After eight years the issue of passive smoking was first

Mentioned in the 1972 U.S Surgeon general’s report(USDHEW 1972).According to this report

Nonsmokers inhale the mixture of the side stream smoke released from the cigarette and

Mainstream smoke exhaled by the smoker and this is a mixture now referred as “secondhand

Smoke” or “environmental smoke” .Since 1964, approximately 250000 nonsmokers are died

By the health problems through the exposure of secondhand smoking .Most of them are

Children and female .However governments throughout the world are undertaking various

Precautions to reduce the exposure to secondhand smoking by prohibition of smoking in public

Areas.

5


Background

The topic of active smoking was first specified in surgeon’s general report on the health

Consequences of active smoking (USDHEW 1964).The issue of passive smoking was first

detected in the 1972 U.S Surgeon general’s report (USDHEW 1972). According to this report

Nonsmokers inhale the mixture of the side stream smoke released from the cigarette and

Mainstream smoke exhaled by the smoker and this is a mixture now referred as “secondhand

Smoke” or “environmental smoke” .Since 1964, approximately 250000 nonsmokers are died by

The health problems caused by the exposure of secondhand smoking, most of them are

Children and female. Following the recognition of damages created by second-hand smoke,

And issues raised by general health groups to scatter that data, smoking in encased public areas

has Considered to be socially unworthy and has become to be developed as a social issue by

Berridge in 1999. Subjection to tobacco smoke through pregnancy, as active smoking or by

exposure to SHS, is connected with antagonistic pregnancy results including low birth weight

(LBW) and Little for gestational age babies because of the impact of tobacco on the

anthropometric Estimations of the newborn [BMC 2013].

Problem Statement

Even now-a-days many people are not familiar about the effects of SHS .The deaths

Caused by SHS are mainly through lung cancer and heart diseases .The total number of

Deaths caused by SHS from heart diseases are 33,951 and from lung cancer are 7333 per

Year .There is thousands of people who are suffering from various diseases caused by

SHS.SHS is a high risk factor to human health, and serious measures should be

Undertake to reduce the health problems caused by SHS.

6


Purpose Statement

The main objective is to enlighten the people about secondhand smoking. People who have no

Idea about SHS are educated about its effects on health, there is a chance of reducing the

Health problems caused by secondhand smoking .Because a person who knows about the

Consequences of passive smoking will avoid exposure to it .Most of the people effected by

Secondhand Smoking is children and women .There is a high necessity to prohibit smoking in

Public areas. The government should undertake required methods to illuminate people

About secondhand smoking.

Research Questions

The paper would like to discuss the following problems caused by secondhand smoking:

1. Is secondhand smoking a serious health implication?

2. What are the effects of SHS during pregnancy?

3. What are the diseases caused in adults due to the exposure of secondhand smoke?

4. What are the respiratory problems caused by SHS?

5. Tobacco industry

6. Secondhand smoking at workplace

7. How to control secondhand smoking?

7


Literature review

“Is second hand smoking a serious health implication?”

Secondhand tobacco smoke or passive smoke was first raised and addressed in U.S Surgeon

general‘s report (The Health Consequences Of Smoking) in the year 1972. Surgeon general Dr.

Jesse Steinfeld was the first person to raise the topic of passive smoke. According to this report

the smoke released from the burning end of the cigarette and the smoke exhaled by the

smoker is mentioned as passive smoke. Now-a-days it is called as “Environmental tobacco

smoke” or “secondhand smoke”. Cigarette smoke releases carbon monoxide which is very

harmful to people with chronic heart diseases and ling diseases. The level of risk is very high in

enclosed areas when compared to outdoor areas.

In 1975 Surgeon general’s report secondhand smoking is mentioned as an” involuntary”

because the exposure of smoking is to a non-smoker is an unavoidable consequence of

breathing air in a smoke-filled environment. Tobacco consists of approximately 7000 chemical

compounds. The IARC (2004) review shows that more than 4000 chemical compounds present

in mainstream smoke are in identical compositions in the secondhand smoke. According to

National research council (1986) assessment in the difference between compositions of

chemical compounds in mainstream smoke and passive smoke shows that some of the

compounds are void at an increasing level to more than 10 times higher in passive smoke

8


compared to mainstream smoke. National Toxicology Program (USDHHS 2000) reports that side

stream smoke consists of more than 250 chemical compounds which are poisonous and

carcinogenic. The cancer causing compounds like polycyclic aromatic hydrocarbons, nitro

compounds, heterocyclic aromatic amines and many various compounds are present in

secondhand smoke.

Polycyclic aromatic hydrocarbons [PAHs] are a group of more than 100 different chemicals.

These Chemicals are generally found in combustion of petroleum products and gasolines. PAHs

caused tumors to animals in laboratory when they breathe them or skin contact for long

periods. Benzo [a] pyrene is one of the chemical in PAHs. During pregnancy if there is a high

exposure to benzo [a] pyrene it will leads to decrease in body weight and birth defects to the

childbirth. According to (IARC 1984) people working at iron, aluminum and coke production

yards are subjected to high exposure of PAHs. These people are highly affected with cancers.

N-Nitrosamines are compounds that are occurred from nitrosation reactions. N-Nitrosamines

Contain high levels cancer causing agents. Tobacco products contain nicotine which emits N-

Nitrosamines when tobacco is burnt. Among the chemical compounds that are released from

nitrosation reaction 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanone (NNK) and N-

Nitrosonornicotine (NNN) are the highly of carcinogenic (Hoffmann and Hecht 1990). In humans

Resistance to the exposure of NNK and NNN varies from one person to the other. People who

are sensitive to the effects of carcinogenic compounds would be at high risk when they use

tobacco or exposed to the smoke released from tobacco.

9


Among aromatic amines aniline, phenyl amine or amino benzene are said to be highly

carcinogenic compounds. 2-naphthylamine and 4-aminobiphenly are known as human bladder

cancer causing agents(IARC 1973; 1974). Aromatic amines are mostly used in rubber and dye

industries. These carcinogenic compounds present in tobacco can cause different types of

tumors and are highly responsible for the cause of urinary bladder cancer for the people

exposed to tobacco smoke or use tobacco products. Secondhand smoking is a serious health

implication. In some juncture people exposed to secondhand smoke are extremely affected

than the active smokers. The reason is that an active smoker has a filter to the cigarette which

filters some of the chemical compounds. Passive smoker inhales the chemical compounds

directly in the form of secondhand smoke which can cause several diseases and it is a serious

health implication.

“Reproductive and perinatal Effects from Exposure to Secondhand Smoke”

Exposure to secondhand smoking during preconception, pregnancy, post-delivery leads to

different types of biological mechanisms that are very harmful to the child and the mother.

Even it is a nine months period Smoking and secondhand smoking can affect the fatal organs

during their development. Motherly smoking during pregnancy period needs to be considered

seriously because it affects the fertility of the pregnancy, sudden infant death syndrome (SIDS),

child growth and development (USDHHS 2004). The effects of secondhand smoking are less

when compared to maternal smoking during pregnancy. But the effects caused are

correlated(USDHHS 2004).

10


Infant mortality is the other effect of maternal smoking or exposure to tobacco smoke. Infant

mortality is defined as the death of newborn one year of birth. Low birth weight (LBW),

preterm delivery, sudden infant death syndrome is the cause for infant mortality. Most of the

newborn that are affected by infant mortality are considered to be the child of smokers and

passive smokers. The death rate of newborn to SIDS decreased more than half from the last

two decades (Ponsonby et al. 2002; American Academy of Pediatrics [AAP] Task Force on SIDS

2005). Exposure of the newborn to Secondhand smoking from mother, father and other family

members can cause SIDS (USDHHS 2006). At the time of infant delivery weight of infant should

be at least 5.5 pounds. If the weight of the child born is less than 5.5 pounds then it called as

low birth weight (LBW). Low birth weight is a result of preterm delivary or intrauterine growth

retardation (IUGR). Low birth weight is occurred mainly due to IUGR ( Coleman et al. 1979).

IUGR is caused by active smoking of the parents or exposure to secondhand smoke. It leads to

the reduce of oxygen levels to the fetus and exposure to CO and nicotine which can cause

uterine and umbilical blood flow (USDHHS 2004).

In recent years, many study’s on secondhand smoking recommend that exposure to tobacco

smoke during pregnancy will affect the Cognitive, Behavioral and Physical Development of the

child (USDHHS 1990). Tobacco smoke contains several carcinogenic compounds that leads to

cancer(USDHHS 1986; Smith et al 2000). Maternal active smoking or maternal passive smoking

during pregnancy results an increase in metabolites of tobacco smoke in amniotic fluid (Smit et

al.1982). Exposure to tobacco smoke causes leukemia and lymphoma in children (Ji et al. 1997,

Infante-Rivard et al. 2000). It also affect the central nervous system of the children whose

mothers are subjected to smoking during their pregnancy (Martin et al. 1982). However there is

11


no adequate evidence to compare the effects cause by active and passive smoking during

pregnancy. But many scientists has proposed that exposure to tobacco smoke during

pregnancy will cause reproductive and developmental problems.

“Cancers among adults through exposure to secondhand smoke”

The risk of active smoking which causes lung cancer was first identified and mentioned in the

surgeon general’s report in 1964 (US department of health, education and welfare 1964).

Scientists have recognized more than 50 carcinogenic compounds and several other toxic

compounds are present in tobacco smoke (USDHHS 1986). Tobacco smoking is the main cause

for lung cancer. People who inhale the side steam and main stream smoke emitted from the

active smoker can also be affected by lung cancer. This was reported 29 years back on USDHHS

1986. The first epidemic study about secondhand smoke and lung cancer was made in 1981; it

showed that nonsmoking women who are married to smokers had a great risk of lung cancer

when compared to nonsmoking women married to nonsmokers (Garfinkel 1981; Hirayama

1981). Numerous investigations were specifically conducted to evaluate the exposure to

secondhand smoking and chances of affecting by lung cancer among nonsmokers. Numeral

studies since 1986 has reviewed specifically about lung cancer associated with secondhand

smoking. All of these studies suggests that exposure to secondhand smoke will increase the risk

of lung cancer.

People are exposing to secondhand smoke at different locations. Work place is one of the

12


locations where people are exposed to secondhand smoke other than home. Large number of

studies demonstrated that large numbers of people are exposed to secondhand smoke in the

workplace and many other locations outside the home National cancer institute 1999. In

national health and nutrition examination survey conducted to working people, in which most

of the people belongs to US, 40 percent of nonsmokers are reported to be exposed to

secondhand smoking at workplace (Pirkle 1996).The concentration of chemical compounds

released from tobacco smoke is similar in home and workplace (Guerin et al.1992; Hammond

1999; [USEPA 1992]). A total number of twenty-five epidemiologic studies have published

information about workplace secondhand smoke exposure and the risk of lung cancer in

nonsmokers. Most of the the people affected by secondhand smoke in workplace are adults.

*People died due to lung cancer caused by secondhand smoking

“Respiratory effects caused from exposure of secondhand smoke”

Tobacco smoke contains chemical compounds like pyridine which produces unpleasant

63,400

100,300

2005-2009(United states)

Female

Male

13


odors(NCI 1999) and other chemical agents like nicotine, formaldehyde, acrolein which can

cause mucosal irritation (Lee et al. 1993). In 1986 surgeon general’s report presented

information about odor annoyance and mucosal irritation caused by secondhand smoking by

reviewing the results of 13 experimental studies (USDHHS 1986). Factors like age can determine

odor response of a person exposed to secondhand smoke as it also relates to the olfactory

acuity (Relwani 1992). Respiratory problems caused by secondhand smoke vary between

persons with asthma and persons without asthma. If people with asthma are exposed to

secondhand smoke they will face a severe respiratory problem like chest tightness, difficult

breathing, cough, and wheeze. Exposure of secondhand smoke on people suffering with mild

asthma will affect the functioning of lungs.

Respiratory problems caused by secondhand smoking

58,200

54,900

1.4

2005-2009(United states)

female

male

14


“History of Tobacco industry”

Tobacco is used to produce different kinds of products. But most of the tobacco in the world is

used for producing cigarettes. In the year 1996, 90 percent of tobacco in US was used for the

production of cigarette (USDA 1996).Tobacco is grown in more than 100 countries all over the

world. It can be grown in any type of weather conditions with less water holding. Top

Producers of tobacco in the world are US, Brazil, china and India (Jacobs et al .2000). Every

country charges high tariffs on tobacco products. Revenue through tobacco products is high

and plays a vital role in economy of each country. Complete ban of tobacco products is not

possible because economy of many countries depends on tobacco products. Cigarettes are one

of the highly promoted and advertised products in every country. In recent years many country

banned the promotion to tobacco products. Cigarette smoking cannot be completely eradicate

but non-smokers can be protected from the exposure of environmental tobacco smoke by

adopting strict prohibition to cigarette smoke in public places and working areas. In 1997 world

health organization proclaim that 134 countries all over the world has adopted strict

prohibition to cigarette smoking in public areas (Wasserman et al. 1991).

“How to control secondhand smoke”

Over the past 30 years, significant efforts are made to control the environmental tobacco

smoke. Most of the countries have adopted strict prohibitions of smoking in public areas and

work zones. Awareness programs about secondhand smoking are undertaking all over the

world to enlighten people about the dangers of second hand smoke. Over the past 10 years

15


percentage of people affected by secondhand smoke is progressively declined [CDXC 2013].

Improved government regulations and serious actions on smoking in public areas at local, state

and national levels [USDHHS 2000]. Surgeon general’s report released in 1986 particularly

mentioned about the tobacco control policies [USDHHS 1986]. It was the first report that

particularly focus on the secondhand smoke and it was the first initiative that provided

evidences scientifically about effects of secondhand smoke. U.S environmental protection

agency (EPA) released a report in 1992 which concluded that secondhand smoke is a group A

carcinogen. The report specifically mentioned that secondhand smoke is responsible for

approximately 3,000 lung cancer deaths of nonsmokers in US. It also explained about the

different health problems caused by exposure to secondhand smoke. This report provided the

additional scientific evidences on secondhand smoke that are not mentioned in (USDHHS

1986).Among all the indoor smoking bans, hospitals are bonded with strict rules against

smoking. In united stated Smoking in hospitals is prohibited since 1992 (JCAHO 1992). Public

support for smoke-free hospital was increased 13 percent between the years 1993 and 2002.

Use of tobacco products in work place is prohibited on both indoor and outdoor areas (ACS

1996).

16


Percentage of deaths among non-smokers during (1988-2012)

Over the past three decades, Percentage of people died through the exposure of

secondhand smoking decreased drastically.

Research instrument

Qualitative approach is used for the data collection. The data on SHS has been collected

through surveying both smokers and non-smokers at Stratford University; Virginia .The smokers

are less in number than non-smokers .A total of 25 people are headed to the survey. Most of

them are between the age group 22-28. This age group are chosen for survey because they

have more knowledge about secondhand smoking and its effects. They were questioned about

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

1988-1991 2007-2008 2009-2012

17


effects of secondhand smoke, measures needed to be undertaken by the government to

reduce second smoking, awareness in uneducated people about secondhand smoking,

necessity of smoking zones in public areas, measures to be introduced to control secondhand

smoking.

Findings

When I raised a question to smokers about SHS their response is that they are smoking in

smoking-zones and they never smoked in public areas .When comes to non-smokers they

replied that they never come through passive smoking in public areas and non-smoking zones.

Even the survey is conducted to less number of people; it is clear that people who are

educated and residents of a country where Strict prohibitions to cigarette smoking in public

areas is established are not affecting by SHS. If an individual have enough knowledge about

SHS then they can avoid exposure to involuntary smoke.

Conclusion

I have noticed that SHS can be eliminated by establishing smoking-zones and by adopting strict

laws and regulations in the under developed countries. Most of the countries implemented

laws against smoking in public areas and work places. Considering the responses of the

participants it is clear that most of the people affected by SHS are from states and countries

where regulations and prohibition of smoking in public areas are not implemented. In some

countries where rates of uneducated people are high, awareness among the people about SHS

18


is necessary. Every country must establish laws of prohibition for smoking in public areas.

People in underdeveloped countries must be educated about risk of SHS through advertising

and awareness programs.

Limitations of Study

In spite of the fact that the research has come to its aims, there are some unavoidable

Limitations .Due to time limit the research was directed to a small size of population who

Attended to Stratford University on 29 October 2015.Now-a-days strict prohibition of smoking

In public areas prevent people from SHS in public areas. Even these measures can’t eradicate

SHS in a residence’s and private areas. Because if any smokers smokes in their houses it will

Affect their Family members and the people surrounding the smoker.

19


References

WAHABI, H.A, MANDIL, ALZEIDAN, BAHNASSY, R. A, A. A & Fayed, (2013). The independent

Effects of second hand smoke exposure and maternal body mass index on the anthropometric

Measurements of the newborn. BMC Public Health, 13(1), 1-12. Doi-10.1186/1471-2458-13-

1058

S. S, MEADOWCROFT and Hawkins, Berkman. "Identifying infants at high-risk for second-hand

Smoke exposure." Child: Care, Health & Development 40, May 2014, no.40

J, MEADOWCROFT, (2011). The Case of Second-hand Smoke in Enclosed Public Places:

Economic and Political Solutions to Social Problems. Review Of Political Economy, 23(2), 233-

248. doi:10.1080/09538259.2011.561559

T. M, Heffernan & T. S. O’Neill, (2013), Addiction. Exposure to second-hand smoke damages

everyday prospective memory, 108(2), 420-426. doi:10.1111/j.1360-0443.2012.04056.x

Anderson PA, Buller DB, Borland R, HELME D, VOEKS JH , BETTINGHAUS EP, Young WF.

Predictors of support for environmental tobacco smoke bans in state government. American

Journal of Preventive Medicine 2006; 30(4):292–9.

PINSKER K, DHALA A, Prezant DJ. Respiratory health consequences of environmental tobacco

smoke. Clinics in Occupational and Environmental Medicine 2006;5(1):139–56.

20


FIGGS LW, BROWNSON RC, CAISLEY LE. Epidemiology of environmental tobacco smoke

exposure. Oncogene 2002;21(48):7341–8.

O’Callaghan M, NAJMAN JM, ALATI R, Al MAMUN A, Williams GM. In utero and postnatal

maternal smoking and asthma in adolescence. Epidemiology 2006;17(2):138–44.

Kharrazi M, Graham S, Pearl M, DELORENZE GN, Kaufman FL, ESKENAZI B, BERNERT JT Jr, Pirkle

J. Environmental tobacco smoke and pregnancy outcome. Epidemiology 2004;15(6):660–70.

task51

Documents