A critical review of the evidence on passive smoking

What I hope to do over the coming weeks is publish as much information on passive smoking that I have in my archives. Firstly what I want to consider is how much does a non smoker inhale from a smoker. The first paper is from 1975 and was published in the New England Journal of Medicine.  (1)

Commuter train   0.004

Commuter bus  0.005

Bus waiting room  0.001

Airline waiting room  0.003

Restaurant  0.004

Cocktail lounge 0.009

Student lounge  0.002

The last figure is the the equivalent of cigarettes per hour based on the nicotine the machine picked up.

The second piece of evidence comes from 1998 and Dr. Keith Phillips of Covance Laboratories in Harrogate UK (2) The conclusions were:

“The most highly exposed workers, both living and working with smokers, would potentially inhale over 20 cigarette equivalents (CE) per annum as based on the upper decile levels. Housewives living with smokers could inhale up to 11 CE per annum as based on the upper decile levels. Locations outside the workplace, including the home, contribute most to overall RSP and ETS particle exposure. Consideration should be given to extending the personal monitoring period in cities where levels appear to be quite low.”

Globalink and Clive Bates of ASH the anti tobacco group were quick to criticise the paper. (3) “The study was undertaken by Covance Labs of Harrogate, UK and the client was the Centre for Indoor Air Research of the US. We know the CIAR is a tobacco industry front – so this is tobacco funded research.”  Although Dr. Phillips was robust in his reply “They try to dismiss it by arguing that our research receives support from . . . the tobacco industry. Our findings are completely independent of any influence from the industry.”

There are two other studies quoted in the Globalink letter both by Dr. Martin Jarvis who is a Trustee of ASH.  (4&5) On 4 Jarvis says “On the basis of the limited data so far available, the dose of nicotine received by the average British non-smoker may represent about 0.5% of that of the heavy cigarette smoker, ranging up to 2% in more heavily exposed individuals.” 5 says “On average, cotinine concentrations in non-smokers with a smoking partner were 0.6–0.7% of those in cigarette smokers.” Other comments included:

“..an upper bound estimate of nicotine dose of 2.5 mg/day for passive smoke exposure has been proposed (Jarvis, 1989). This would translate to the equivalent of about one-fifth of a cigarette per day or 0.7% of the average smoker’s dose of nicotine. […] comparisons of cotinine values in ETS-exposed nonsmokers with those measured in smokers ranged from 0.1% to 2%. One analysis proposed that, on average, nonsmokers’ cotinine levels are 0.5-0.7% of those found in cigarette smokers (Jarvis, 1989 *).”

Martin Jarvis adds (for this note): “studies based on cotinine measurements in non-smoking children exposed in the home continue to show nicotine intake equivalent to smoking 100-150 cigarettes per year where both parents smoke*. Although exposure levels in adults are lower than this in general, studies in particular groups, (eg. non-smoking adults working in smoky bars) show nicotine intakes as high as half a cigarette per day.”

The next paper is from the late Dr. KWE Denson who was sceptical that passive smoking caused sudden infant death syndrome (SIDS) or cot deaths. (6&7) He quoted from his studies Pirkle’s 1996 study where the uptake from nicotine concentrations were between 1/300th and 1/500th of that of a smoker.  In the long link (8) there appears to be much evidence compared to smokers the dosage is considerably lower.

If you also visit Marcus Aurelius’ blog (9) who is an industrial filtration expert.  On these two links (10&11) he reviews the academic data from a number of universities including John Hopkins., he concludes:

“The three air quality test results replicated by three separate credible organizations prove that secondhand smoke concentrations when compared to OSHA permissible exposure limits (pel) for secondhand smoke, range between 15 – 25,000 times SAFER than OSHA regulations; in other words NOT A HEALTH HAZARD. (PEL)’s are the OSHA safe acceptable level of exposure to humans for an 8 hour day, 40 hour per week time period.”

The three air quality test results replicated by three separate credible organizations prove that secondhand smoke concentrations when compared to OSHA permissible exposure limits (pel) for secondhand smoke, range between 15 – 25,000 times SAFER than OSHA regulations; in other words NOT A HEALTH HAZARD. (PEL)’s are the OSHA safe acceptable level of exposure to humans for an 8 hour day, 40 hour per week time period.”

I should also add  the UK government’s report into passive smoking published in (12) November 2004 the Scientific Committee on Tobacco and Health (SCoTH). Written by Action on Smoking and Health’s  (ASH) Trustee Dr. Martin Jarvis  on page 8  (SCoTH) numbering he writes:

The increased risk associated with exposure to SHS is about 25%,
a substantial fraction of the risk from active smoking, although
uptake of smoke by non-smokers is typically only about 1% of that
by active smokers

I am sure there is much more to read and review. Most importantly it seems everyone agrees that even at its most extreme exposures consumption is less than 1 cigarette a day. What to the active smoking papers say on lung cancer and heart attacks at that level of active smoking?

1. http://www.legacy.library.ucsf.edu/tid/hmf16b00/pdf

2. http://www.ncbi.nlm.nih.gov/pubmed/9591162

3. http://www.globalink.org/tobacco/docs/ets/Covence.shtml

4. http://www.ncbi.nlm.nih.gov/pubmed/2645516?dopt=Abstract

5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1747624/pdf/v010p00368.pdf

6. http://www.springerlink.com/content/w5rrkdftaha6xgl7/

7. http://www.ncbi.nlm.nih.gov/pubmed/11768040

8. http://books.google.co.uk/books?id=nZ9mxo43gZIC&pg=SA30-PA6&lpg=SA30-PA6&dq=pirkle+1996+estimating+Exposure+to+Environmental+Tobacco+Smoke&source=bl&ots=1VM-OCJOYT&sig=lqBoInTJ9dtN7ljZWQV8IfVmUQ4&hl=en&ei=CXC1TfK_FIKKhQePgZXkDw&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEEQ6AEwBA#v=onepage&q&f=false

9. http://www.blogger.com/profile/01360899036394438711

10. http://cleanairquality.blogspot.com/2006/11/is-secondhand-smoke-health-hazard.html

11. http://cleanairquality.blogspot.com/2007/11/johns-hopkins-air-quality-testing-of.html

12. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4101475.pdf

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5 Responses to A critical review of the evidence on passive smoking

  1. Sandra says:

    Why are these facts and figures being ignored and smoking bans are gaining so much ground.
    We will have bans in our own homes and cars and yet the science behind these bans is FAKE.

  2. daveatherton says:

    Hi Sandra, I think most people are admiring the Emperor’s new clothes, while the rest with malice of forethought are misleading us.

  3. Junican says:

    I was having a think a couple of days ago. What was exercising my mind was the difference between lung cancer DEATH records (which are very good) and DIAGNOSIS records (of which I have read nothing). There must surely be such diagnosis records (“40 000 per an diagnosed etc”), but where are they I wonder?

    This led me on to another idea.

    I recalled the scandal (in a Liverpool children’s’ hospital, I think) where surgeons were extracting organs from dead children without permission and storing them ‘for research’. The thought occurred to me that if such blatantly unacceptable events could occur, what is there to stop there being in place a routine system for extracting samples from the organs of deceased people during the course on autopsies? For example, one could think of a young man killed in a road accident, or a middle aged person killed in a work accident, or a possible poisoning death or a murder. And then, of course, there are all the bodies which are donated to medical science. One could certainly see the advantages of such a system from the point of view of ‘medical researchers’. In a roundabout way, such a system allows experimentation on human beings, even if only in a discovery sense. Would there be anything immoral or illegal in it? Could such a system be conducted in secret (in the national interest!)?

    In view of the Liverpool event, I cannot see how it can possibly not be so. Think about the wealth of information which could be gained about the condition of human bodies at a particular age which have been accidentally killed! Lung condition? Heart? Kidneys? Blood? Beginnings of cancers? Etc. Over say 10 years, such info would be a treasure trove of knowledge!

    Am I being fanciful? If not, I wonder where all this knowledge is held and assessed?

  4. Pingback: ASH will not be having a good Christmas | LifestyleReviews

  5. Pingback: An open letter to Professor Terence Stephenson and Professor Dame Sally Davies | LifestyleReviews

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