Docstoc

Passive smoking what are the effects

Document Sample
Passive smoking what are the effects Powered By Docstoc
					  Royal College of Physicians of
             London

     Tobacco Advisory Group




2. Passive smoking
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
    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; 315:980-988
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
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
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
Proportion of non-smokers who live in
a household with at-least one smoker
 60
         Percent
 50      47
                    40
 40

 30                                                   26
                               21
                                          19                     18
 20
                                                                            12
 10                                                                                6

  0
       under      16-24      25-34      35-44       45-54      55-64      65-74   75+
        16

 Source: SCPR (1996) Health Survey for England, 1995 (under 16s assumed to be
 non-smokers)
Passive smoking & children

•   SIDS
•   Middle ear infection (“glue ear”)
•   Asthma
•   Bronchitis & pneumonia
•   Respiratory tract infection
•   Low birth weight
•   Meningococcal infections
       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
Passive smoking & other health impacts

•   Asthma
•   Eye irritation
•   Coughing
•   Nausea
•   Headaches
•   Unpleasant smell
Attitudes towards smoking
                                                              Smoking status

Percent agreeing that smoking                  Current        Ex-      Never    All
should be restricted…                          smoker        smoker   smoked   adults
                             …at work             70          89         92     86
                   …in restaurants                72          91         94     88
                             …in pubs             28          55         67     54
         …in other public places                  84          87         89     87




 Source: Office of National Statistics Omnibus survey 2002

				
DOCUMENT INFO