Public, Meet “Sound Science” and get the facts about Second Hand Smoke

June 22nd, 2010

The current New England Journal of Medicine (June 17, 2010; No. 24V.362:2319-2325) has an important article offered as free full text to online readers entitled, “Regulation of Smoking in Public Housing” (Winnikoff, Gottlieb and Mello). The introduction summarizes how the regulation of smoking in public and workplaces has led to very significant improvements in public health while residences remain outside of the realm of regulation. A summary of their recommendation of banning tobacco in public housing appeared in the LA Times last week as well, here.

Given the fact that over seven million people live in public housing because they cannot afford to live elsewhere, these residents are basically required to become unwilling consumers of tobacco by-products. Of course, multi-unit housing is quite common in the private sector with a small but slowly increasing number of landlords mandating (but rarely enforcing) lease stipulations requiring smoking to be done outdoors. Property values come into play given the fact that smoke contaminates the environment with “… more than 250 poisonous gasses, metals and chemicals… .” Taking the extreme measures required to decontaminate these premises from residues (considered a tertiary form of passive tobacco consumption) also assumes landlords possess the knowledge of what needs to be done and the financial resources to expend on the astronomical costs of remediation.

A key concept described is that smoke cannot be prevented from drifting throughout an apartment nor can it be stopped from entering surrounding units. Residues from these poisonous substances are present in the urine of those exposed to smoke by both inhalation and contact with nicotine-contaminated materials.

Remember the discussions that followed the 9/11 attacks about the uselessness of employing duct tape and plastic sheeting to combat chemical warfare? Beliefs that gases coming from lit cigarettes can be contained within four walls, or absorbed by air purifiers, are part of a faulty public perception based in advertising.

Industry is happy to exploit the ever-present human desire for immediate gratification through fast acting chemicals to kill bugs and clean the furnace, regardless of the collateral damage done by those products. We want to cover the walls and floors with something cheap and decorative that will last forever.

We have a Disneyland-ish expectation that the poisons around us dissipate within hours, if not minutes. Affected people are expected to spring back to full health and vigor, like those animated characters in cartoons who have been flattened by bulldozers or dropped off of cliffs.

We measure residues by smell, never considering that most products today are marketed with perfumes or masking fragrances to hide the odors that normally signal chemical hazards. Carbon monoxide is odorless, yet we evacuate neighboring apartments when a stove leaks, and monitors are legally required in many states. Why aren’t we just
as concerned with cigarette smoke?

We now know that the dangers of tobacco are not limited to the delayed effects of exposure to its carcinogenic properties. Smoking bans have led to impressive reductions in cardiac and respiratory disorders in non-smokers, merely through restrictions in areas such as workplaces, occupied for only part of the day.

Imagine being freed of contact with such hazardous substances in smoke-free residences. Those choosing to smoke can always go to an outside designated location. Where will you go with your three-month-old infant or elderly parent suffering from COPD? Eventually, the costs of environmentally induced illnesses will lead to recognition of just how easily toxic fumes spread within buildings and permit a NIOSH or OSHA-like agency to assess indoor air quality within residential settings. That will lead to least toxic formulas being developed for pesticides, construction materials, cleaning products etc. Application methods will not just be determined by efficacy but also by residual amounts present in and around locations of product usage.

Please write a letter to the editor of this journal and thank them for offering important articles like this one for free access to all. Then ask them to solicit and publish research on other indoor air quality issues.

Be an armchair activist. Only through such articles can we remove the taint of industry claiming there is no ‘sound science’ to restrain their right to sell any product or service. However, without public awareness of that science, we can’t make informed decisions as consumers and voters.

My letter (unpublished) was as follows:

To the Editor,

Thank you for offering free, public access to the full text of the article, “Regulation of Smoking in Public Housing.”. This valuable information is now well summarized with references to sound science and policy for use by a concerned public.

This effort to reduce preventable morbidity and mortality among residents of public housing also brings to the forefront some long-avoided issues in indoor air quality. Measurements of toxic particulates drifting from application sites for paints, adhesives, pesticides or cleaning solvents into adjacent air spaces deserves the same attention as the migration of tobacco smoke. For instance, studies of environmental nicotine persistence are typical of how many toxic chemicals bond to dust and become embedded in our permeable belongings.

Citizens require oversight of residential air quality just as workers receive certain protections through the NIOSH and OSHA agencies. It begins with full disclosure of chemical use in and around residences so occupants have the potential to choose relocation over health risks. Physicans cannot respond appropriately ti illnesses induced by toxic exposures in the absence of patient awareness.

Barbara Rubin

update: see this article which documents there is no level of exposure to second hand smoke that is ‘safe’:

and this Lancet article, calculating the numbers exposed to second hand smoke:

Categories: Letters, New England Journal of Medicine

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