Hold your breath: No safe level of tobacco smoke exposure?

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Apparently even a whiff of tobacco smoke can threaten your health, according to a report released yesterday by U.S. Surgeon General Regina Benjamin. The report, “How Tobacco Smoke Causes Disease,” insists upon a policy of zero-tolerance toward second-hand smoke and asserts that even low-level exposure to cigarette smoke, whether inhaled directly, or via second-hand exposure, can cause cardiovascular and inflammatory disease. To this end, the report uses a lot of frightening language and claims that any amount of smoke can damage your DNA and cause cancer, or provoke inflammatory vessel changes and heart attacks. Even more disturbing and counter to public health, the report maintains that while quitting smoking can reduce your risk of heart attack and stroke, cutting back will have very little impact on health. “If you’re a light active smoker, that’s almost as bad as being a heavy active smoker,” says Dr. Stanton Glantz, a contributor to the report and director of the University of California San Francisco’s Center for Tobacco Control. He adds, “That’s because the inflammatory responses occur at very, very low doses. It’s like you’ve turned the system on or you’ve turned it off.”

Upon reading this statement, ACSH’s Dr. Gilbert Ross is left wondering whether basic toxicology and cancer-causation principles were considered in the drafting of the Surgeon General report. “Whether indirect exposure to tobacco smoke leads to disease is a matter of dose — the amount of smoke it takes to trigger adverse health outcomes such as heart disease or cancer — but the question of dose-response and exposure levels never made it into the report.” He further observes: “It seems to me that Dr. Glantz is sending the message to addicted smokers that they shouldn’t even bother trying to quit gradually. Even though many smokers have quit by first cutting down — and completely oblivious to the SG Report where it states that harm occurs incrementally, it’s worse the more you smoke —Dr. Glantz’s advice amounts to: ‘You may as well keep smoking.’ He wants people to simply quit cold turkey, but the reality is that most of America’s 45 million addicted smokers will say, ‘Well, I’d really like to, but I can’t.’ What about them, Dr. Glantz?”

ACSH’s Cheryl Martin wishes Dr. Glantz had simply said, “People shouldn’t believe that simply smoking fewer cigarettes will not harm you,” rather than sending mixed messages that distort the science.

“Who would possibly believe that a mere inhalation of second-hand smoke will cause cancer or heart attacks?” asks ACSH President Dr. Elizabeth Whelan. “The easiest way to lose your argument is to overstate your case, which is precisely what this report has done. The credibility of public health has been stained by this report.”

On the other hand, as ACSH’s Lana Spivak points out, the report also provides some valid reasons to avoid second-hand smoke, particularly for parents who smoke in the home. “I know that this report is very alarmist, but if I were a smoking parent reading it, I might think twice before smoking in the house or car and around my kids. There is an obvious qualitative and quantitative difference between transient exposure to second-hand smoke — which this report tries to scare people about — and ongoing exposure to second-hand smoke, such as what happens when you frequently smoke in the home.”