Environmental Tobacco Smoke
(secondhand smoke)

ETS has been classified as a Group A carcinogen under the Environmental Protection Agency's carcinogen assessment guidelines, a rating used only for substances proven to cause cancer in humans. There is no safe dose; any exposure to ETS can cause harm (Jinot, Bayard, US EPA, NCI, & ICF Inc., 1993).

The nicotine concentration in the air ranges from 0.1 mcg/m3 for those in non-smoking homes up to 10 mcg/m3 for those who live with smokers. Exposure in motor vehicles and workplaces that permit smoking including bars and casinos can be much higher (Froines, 2005)

Nearly 9 out of 10 nonsmoking Americans are exposed to ETS, as measured by the levels of cotinine in their blood (Centers for Disease Control [CDC], 1999).

Research on environmental tobacco smoke has produced important findings, which include:

• ETS is responsible for approximately 3,400 lung cancer deaths annually in U.S. nonsmokers (National Cancer Institute, 1999; Jinot, Bayard, US EPA, NCI, & ICF Inc, 1993).
  
  
• ETS is estimated to account for up to 69,600 heart disease deaths annually
  (National Cancer Institute, 1999).
  
  
• ETS exposure is a cause of:
  
  
  • Developmental Effects
    
    • low birth weight
    • sudden infant death syndrome (SIDS)
    • pre-term delivery
      
      
  • Respiratory System Effects:
    
    • chronic respiratory symptoms in children
    • middle ear infections
    • new cases of asthma in children and adults who have not previously displayed symptoms
    • frequency of episodes and severity of symptoms in asthmatic children and adults
    • respiratory tract infections such as bronchitis and pneumonia in children
    • eye and nasal irritation in adults
      
      
  • Cancer
    
    • lung cancer
    • nasal sinus cancer
    • breast cancer, primarily in younger, pre-menopausal women
    • cervical cancer
      
      
  • Cardiovascular effects
    
    • heart disease mortality (deaths)
    • acute and chronic heart disease morbidity (illness)
    • altered vascular properties
      
      (Froines, 2005; National Cancer Institute, 1999;
      Jinot, Bayard, US EPA, NCI, & ICF Inc, 1993).