1. E FFECTS OF S ECONDHAND S MOKE Pat McKone, Director American Lung Association of the Upper Midwest

3. W E ’ VE COME A LONG WAY SINCE,…

4. W HAT IS E NVIRONMENTAL T OBACCO S MOKE (ETS)..S ECONDHAND SMOKE ?

5. I NDOOR A IR P OLLUTION 90% OF TIME SPENT INDOORS

6. S URGEON G ENERAL R EPORT

7. W HAT ’ S IN T OBACCO S MOKE ? Particulates carbon monoxide nicotine benzene nitrosamines polycyclic hydrocarbons 3,000 - 4,000 others

9. I T ’ S A SERIOUS DANGER TO HEALTH Secondhand smoke is a leading cause of preventable death in the U.S. Mokdad, AH et al. “Actual Causes of Death in the United States, 2000.” JAMA. 2004; 291: 1238-1245. Secondhand smoke causes at least 38,000 deaths annually in U.S. Centers for Disease Control and Prevention. “Annual smoking-attributable mortality, years of potential life lost, and productivity losses.” MMWR. 2005; 54: 625-628 Hundreds of studies have documented secondhand smoke as a cause of serious health problems.

10. U.S. S URGEON G ENERAL ’ S 2006 R EPORT C ONCLUSIONS No Risk Free Level of Exposure

11. T OBACCO S MOKE The concentration of some chemicals in side-stream smoke is 10 x greater than in main-stream smoke.

12. H EALTH E FFECTS ON C HILDREN Fetal growth retardation SIDS Respiratory problems in children Asthma in children Eye and nasal irritation Middle ear infections in children Lung cancer Nasal sinus cancer Heart disease Mortality due to heart disease (1997 Comprehensive Study by Cal EPA)

13. O THER H EALTH E FFECTS Pre-term delivery Asthma induction in adults Breast cancer in younger (primarily pre-menopausal) women Acute and chronic heart disease Altered vascular properties About 49,000 deaths (not including breast cancer) (2005 Report Expanded Impacts)

14. E FFECTS ON THE H EART Interferes with normal functioning of the heart, blood and vascular systems Increases “stickiness” of platelets even with brief exposures Damages the lining of blood vessels

16. L UNG C ANCER All major health authorities agree that secondhand smoke causes cancer: U.S. Surgeon General linked SHS to lung cancer. U.S. Dept of Health & Human Services. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. 1986; p. 7 Classified as a Group A carcinogen by U.S. Environmental Protection Agency, meaning it is known to cause cancer in humans. U.S. EPA, Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. 1992; p. 5-68

18. L UNG C ANCER

20. V ENTILATION According to ASHRAE, the organization that establishes industry standards for ventilation: The only means of effectively eliminating health risks associated with indoor exposure to SHS is to ban smoking activity. Engineering approaches, such as ventilation and air cleaning, cannot be relied on to control the health risks associated with SHS exposure. Samet, J et al. “ASHRAE position document on environmental tobacco smoke.” 2005.

21. T HIRDHAND SMOKE Residual chemicals left on a variety of indoor surfaces The science is still emerging

22. W HAT CAN WE DO ? Only Smoke-free policies fully protect NO SMOKING sections do not protect Cleaning the air or ventilating buildings does not fully protect non-smokers