WASHINGTON – Separate smoking sections don't cut it: Only smoke-free buildings and public places truly protect nonsmokers from the hazards of breathing in other people's tobacco smoke, says a long-awaited surgeon general's report.
Some 126 million nonsmokers are exposed to secondhand smoke, what U.S. Surgeon General Richard Carmona repeatedly calls "involuntary smoking" that puts people at increased risk of death from lung cancer, heart disease and other illnesses.
Moreover, there is no risk-free level of exposure to someone else's drifting smoke, declares the report issued Tuesday — a conclusion sure to fuel already growing efforts at public smoking bans nationwide. Fourteen states have passed what are considered comprehensive smoke-free workplace laws, those that include restaurants and bars.
But the surgeon general is especially concerned about young children who can't escape their parents' addiction in search of cleaner air: Just over one in five children is exposed to secondhand smoke at home, where workplace bans don't reach. Those children are at increased risk of SIDS, sudden infant death syndrome; lung infections such as pneumonia; ear infections; and more severe asthma.
"Exposure to secondhand smoke remains an alarming public health hazard," Carmona said. "Nonsmokers need protection through the restriction of smoking in public places and workplaces" — and by smokers voluntarily not puffing around children.
The report won't surprise doctors. It isn't a new study but a compilation of the best research on secondhand smoke, the most comprehensive federal probe since the last surgeon general's report on the topic in 1986, which declared secondhand smoke a cause of lung cancer in nonsmokers.
Since then, numerous other health agencies have linked to secondhand smoke to heart disease and other illnesses. Earlier this year, California health officials estimated that secondhand smoke kills about 3,400 nonsmoking Americans annually from lung cancer, 46,000 from heart disease, and 430 from SIDS.
The new surgeon general's report doesn't re-tally the deaths, but it cites that toll.
The tobacco industry and some businesses, particularly restaurant and bar owners concerned about loss of smoking customers, have challenged some of the broadest public smoking bans in cities and states.
The new report gives new scientific ammunition against those challenges, said Matthew Myers of the Campaign for Tobacco-Free Kids.
"There is no longer a scientific controversy that secondhand smoke is a killer," he said. The report "eliminates any excuse from any state or city for taking halfway measures to restrict smoking, or permitting smoking in any indoor workplace."
Among other findings:
_Separating smokers from nonsmokers, cleaning the air and ventilation systems don't eliminate exposure to secondhand smoke.
_There is good evidence that comprehensive smoking bans, like those in New York City and Boston, don't economically hurt the hospitality industry.
_Workplace smoking restrictions not only reduce secondhand smoke but discourage active smoking by employees.
_Secondhand smoke can act on the arteries so quickly that even a brief pass through someone else's smoke can endanger people at high risk of heart disease. Don't ever smoke around a sick relative, Carmona advised
_Living with a smoker increases a nonsmoker's risk of lung cancer and heart disease by up to 30 percent.
_There isn't proof that secondhand smoke causes breast cancer, although the evidence is suggestive. California earlier this year cited that link in becoming the first state to declare secondhand smoke a toxic air pollutant.
_On the plus side, blood measurements of a nicotine byproduct show that exposure to secondhand smoke has decreased. Levels dropped by 75 percent in adults and 68 percent in children between the early 1990s and 2002. However, not only has children's exposure declined less rapidly, but levels of that byproduct among children are more than twice as high as in nonsmoking adults.