2' Passive smoking

1
2. Passive smoking

• Royal College of Physicians of London
• Tobacco Advisory Group

2
Passive smoking what are the effects?

• Fatal risks
• Several hundred lung cancers (UK)
• Several thousand heart disease cases
• Non-fatal impacts
• Lung function, cough, wheeze, phlegm
• Asthma aggravation
• Children
• Sudden infant death, middle ear infection, lung
  disease
• Unborn child
• Spontaneous abortion, perinatal death, preterm
  birth, low birthweight

3
Passive smoking lung cancer Risk in
non-smoking women living with smoker compared to
non-smoker

• compelling confirmation that passive smoke is a
  cause of lung cancer
• Excess risk of lung cancer 24
• Corresponds to 100s of deaths in the UK annually

Hackshaw et al. BMJ 1997 315980-988
4
Passive smoking heart disease Risk in
non-smokers living with smoker compared to
non-smoker

• Exposure to passive smoke increases risk of
  ischaemic heart disease by 25
• Equates to half the risk of smoking 20 cigarettes
  a day
• No significant bias or confounding

Law et al. BMJ 1987 315 973-980
5
Passive smoking heart / circulatory disease

• Dramatic non-linear effect
• 1 of the smoke exposure, but half the heart
  disease risk of a 20/day smoker
• 12,000 cases of heart disease annually (UK)
• Though with some uncertainty
• Increased risk of stroke
• Suggested mechanism - platelet aggregation

6
Passive smoking respiratory disease

• Exposure delivers carcinogens to all parts of the
  respiratory tract
• Associated with decreased lung function
• 40 60 increase risk of aggravating symptoms of
  pre-existing asthma

7
Proportion of non-smokers who live in a household
with at-least one smoker
Source SCPR (1996) Health Survey for England,
1995 (under 16s assumed to be non-smokers)
8
Passive smoking children

• SIDS
• Middle ear infection (glue ear)
• Asthma
• Bronchitis pneumonia
• Respiratory tract infection
• Low birth weight
• Meningococcal infections

9
Passive smoking fetus

• Smoking during pregnancy is a cause of
• Lower birth weight
• Increased risk of stillbirth
• 27 higher rate of spontaneous abortion (4300 per
  year)
• Excess perinatal deaths due to maternal smoking
  420 pa in England Wales

10
Passive smoking other health impacts

• Asthma
• Eye irritation
• Coughing
• Nausea
• Headaches
• Unpleasant smell

11
Attitudes towards smoking
Source Office of National Statistics Omnibus
survey 2002