GOVERNMENT STUDIES OF HEALTH EFFECTS OF ENVIRONMENTAL TOBACCO
SMOKE
New
Surgeon General's Report Focuses on the Effects of Secondhand Smoke
The
following is from the June 27, 2006 Surgeon General's press release: U.S.
Surgeon General Richard H. Carmona today issued a comprehensive scientific
report which concludes that there is no risk-free level of exposure to
secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work
increase their risk of developing heart disease by 25 to 30 percent and lung
cancer by 20 to 30 percent. The finding is of major public health concern due
to the fact that nearly half of all nonsmoking Americans are still regularly
exposed to secondhand smoke. The report, The Health Consequences of
Involuntary Exposure to Tobacco Smoke, finds
that even brief secondhand smoke exposure can cause immediate harm. The
report says the only way to protect nonsmokers from the dangerous chemicals in
secondhand smoke is to eliminate smoking indoors. "The report is a crucial warning sign to
nonsmokers and smokers alike," HHS Secretary Michael Leavitt said.
"Smoking can sicken and kill, and even people who do not smoke can be
harmed by smoke from those who do." Secondhand smoke exposure can cause
heart disease and lung cancer in nonsmoking adults and is a known cause of
sudden infant death syndrome (SIDS), respiratory problems, ear infections, and
asthma attacks in infants and children, the report finds. "The health
effects of secondhand smoke exposure are more pervasive than we previously
thought," said Surgeon General Carmona, vice admiral of the U.S. Public
Health Service. "The scientific evidence is now indisputable:
secondhand smoke is not a mere annoyance. It is a serious health hazard that
can lead to disease and premature death in children and nonsmoking
adults." Secondhand smoke
contains more than 50 cancer-causing chemicals, and is itself a known human
carcinogen. Nonsmokers who are exposed to secondhand smoke inhale many of the
same toxins as smokers. Even brief exposure to secondhand smoke has immediate
adverse effects on the cardiovascular system and increases risk for heart
disease and lung cancer, the report says. In addition, the report notes that
because the bodies of infants and children are still developing, they are
especially vulnerable to the poisons in secondhand smoke. "The good news
is that, unlike some public health hazards, secondhand smoke exposure is easily
prevented," Surgeon General Carmona said. "Smoke-free indoor
environments are proven, simple approaches that prevent exposure and
harm." The report finds that even the most sophisticated ventilation
systems cannot completely eliminate secondhand smoke exposure and that only
smoke-free environments afford full protection. ... He emphasized, however, that sustained efforts are
required protect the more than 126 million Americans who continue to be
regularly exposed to secondhand smoke in the home, at work, and in enclosed
public spaces. To help communicate the report findings as widely as possible,
the Surgeon General unveiled an easy-to-read guide with practical information
on the dangers of secondhand smoke and steps people can take to protect
themselves. Copies of The Health Consequences of Involuntary Exposure to
Tobacco Smoke: A Report of the Surgeon General and related materials are available on the Surgeon
General's Web site by clicking here. To access
the press release, click above. To access a summary of the 6 major
conclusions of the Surgeon General's report, click here.
To access a glossy brochure based on the report (this is in pdf format and is a
large megabite document), click here.
California
Air Resources Board (ARB) Identifies Second-Hand Smoke as a "Toxic Air
Contaminant"
On
January 26, 2006, the California Air Resources Board (ARB) identified
environmental tobacco smoke (ETS), or second-hand smoke, as a Toxic Air
Contaminant (TAC). ETS is now formally identified as an airborne toxic
substance that may cause and/or contribute to death or serious illness. ARB's
action to list ETS as a TAC was based on a comprehensive report on exposure and
health effects of ETS. "This new report reaffirms many of the adverse
health effects associated with ETS, especially in children who live in homes
where smoking occurs," said ARB Chairman, Dr. Robert Sawyer. "It also
raises new concerns about its effects on women. All this strongly supported the
need for the Air Board to identify ETS as a serious health threat."
Second-hand smoke is a complex mixture of compounds produced by burning of
tobacco products. ETS is also a source of other toxic air contaminants such as
benzene, 1,3 butadiene, and arsenic. In California each year, tobacco smoke is
responsible for the release into the environment of 40 tons of nicotine, 365
tons of respirable particulate matter, and 1900 tons of carbon monoxide. As
required by State law, the ARB evaluated exposures to ETS, while the Office of
Environmental Health Hazard Assessment (OEHHA) assessed the health effects from
these exposures. The OEHHA evaluation clearly established links between
exposure to ETS and a number of adverse health effects, including some specific
to children and infants. These include premature births, low birth-weight
babies, and Sudden Infant Death Syndrome (SIDS). Other effects of ETS on
children include the induction and exacerbation of asthma, and infections of
the middle-ear and respiratory system. The OEHHA evaluation also found links
between ETS exposure and increased incidences of breast cancer in non-smoking,
pre-menopausal women. ETS had already been linked to adult incidences of lung
and nasal sinus cancer, heart disease, eye and nasal irritation, and asthma. "The
ARB's action rightfully puts second-hand tobacco smoke in the same category as
the most toxic automotive and industrial air pollutants," OEHHA Director
Joan Denton said. "Californians, especially parents, would not willingly
fill their homes with motor vehicle exhaust, and they should feel the same way
about tobacco smoke." Now that
ETS is identified as a toxic air contaminant, the ARB must evaluate the need
for action to reduce exposures. To access the press release announcing this
report, click above. To access more on the report, go to the Environmental
Tobacco Smoke section of the Air Resources Board web site by clicking here.
A
scientific working group of 29 experts from 12 countries convened by the
Monographs Programme of the International Agency for Research on Cancer (IARC)
of the World Health Organization (WHO), Lyon, France, has reviewed all
significant published evidence related to tobacco smoking and cancer, both active
and involuntary. Its conclusions, released in June, 2002, unsurprisingly
confirmed the cancer-causing effects of active smoking, which an earlier
working group had considered back in 1986. However, it now concluded its
evaluation of the carcinogenic risks associated with involuntary smoking, and
IARC now classifies second-hand smoke as carcinogenic to humans. This report is
very significant because it places a prestigious international organization
officially on record as finding secondhand smoke to be a carcinogen, i.e., a
substance which causes cancer in humans. To access the report on both smoking
and involuntary smoking, which was published by IARC in July, 2004, click here. To access
the portion of the IARC report on "Involuntary Smoking," click above.
10th Report
on Carcinogens; Issued by U.S. Public Health Service
The
U.S. Department of Health and Human Services through its Public Health Service,
National Toxicology Program on December 11, 2002 issued its 10th Report on
Carcinogens. The report includes a list of all 228 known carcinogens --
cancer-causing agents. The 10th Report added 15 carcinogens which had not
previously been listed. Included among the list of carcinogens is "Tobacco
Related Exposures" which includes Environmental Tobacco Smoke, Tobacco
Smoking, and Smokeless Tobacco. The report states that each of these tobacco
related exposures are carcinogenic. To access the full report, click above and
scroll down to "Tobacco Related Exposures." To directly access the
section on "Tobacco Related Exposures," in pdf format, click here. For
additional information on the 10th Report, including a Factsheet, click here.
The
ninth official federal government report, issued on May 15, 2000, listed the
218 substances known to cause cancer. This report, for the first time,
specifically listed ETS as a "known human carcinogen," based on
evidence that indicates there is a causal relationship between passive exposure
to tobacco smoke and lung cancer. This report succinctly provides information
about the composition and properties of ETS, as well as information about
levels of exposure to ETS in various settings. To access the press release
announcing this report, with specific mention of the addition of ETS to the
listing of carcinogens, click here. It appears that
the 9th Report is no longer accessible, but instead you are directed by the
NIEHS web site to the 10th Report which is described in the above paragraph and
may be accessed by clicking above.
National Report
on Human Exposure to Environmental Chemicals, including in ETS
The
National Report on Human Exposure to Environmental Chemicals provides an ongoing assessment of the U.S.
population's exposure to environmental chemicals using biomonitoring.
Biomonitoring is the assessment of human exposure to chemicals by measuring the
chemicals or their metabolites in human specimens such as blood or urine. The
first National Report on Human Exposure to Environmental Chemicals was issued in March 2001, and presented exposure data
for 27 chemicals from NHANES 1999, including Environmental Tobacco Smoke. The Second
Report, released in January 2003,
presents biomonitoring exposure data for 116 environmental chemicals (including
the 27 in the first Report) for
the noninstitutionalized, civilian U.S. population over the 2-year period
1999-2000. The Second Report also
presents exposure data for the U.S. population divided into age, gender, and
race/ethnicity groups. To access the full Second Report, click above. To access information, in pdf format, on Tobacco
Smoke: Cotinine from the Second
Report, click here.
California
Office of Environmental Health Hazard Assessment of ETS
This
site includes the final report adopted in September, 1997 titled Health
Effects of Exposure to ETS. This
report, by the California Environmental Protection Agency, is one of the most
comprehensive reports yet compiled and identifies the many health dangers of
ETS. The site also contains the draft updates to the 1997 report; the draft was
issued in 2003, revised and re-issued in October, 2004. To access each of these
important documents, plus more, click above.
The
U.S. Environmental Protection Agency (EPA) in 1992 published this landmark
assessment of the respiratory health risks of passive smoking (Respiratory
Health Effects of Passive Smoking: Lung Cancer and Other Disorders;
EPA/600/6-90/006F). The report concluded that exposure to environmental tobacco
smoke (ETS) -- commonly known as secondhand smoke -- is responsible for
approximately 3,000 lung cancer deaths each year in nonsmoking adults and
impairs the respiratory health of hundreds of thousands of children. This Fact
Sheet, prepared by the EPA, summarizes the findings of this landmark report;
click above for the Fact Sheet. [Note: This EPA report was the subject of an
intensive legal challenge by the tobacco industry, but, in a December 11, 2002
decision, the U.S. Court of Appeals for the 4th Circuit unanimously upheld the
validity of the EPA report. The decision may be accessed by clicking here. The
tobacco companies who had challenged the validity of the EPA report decided not
to appeal this decision. Therefore, the findings of the EPA report stand and
are subject to no further legal challenge.] To access the full 1992 EPA report,
click here.
NIOSH
-- the National Institute for Occupational Safety & Health -- has
determined that environmental tobacco smoke (ETS) is "potentially
carcinogenic to occupationally exposed workers," and that "workers
should not be involuntarily exposed to tobacco smoke." NIOSH recommends
that "the best method for controlling worker exposure to ETS is to
eliminate tobacco use from the workplace and to implement a smoking cessation
program." NIOSH has a variety of reports and materials which can be
accessed from its home page by doing a search for "environmental tobacco
smoke." The NIOSH home page can be accessed by clicking above. To obtain
the NIOSH Carcinogen List, which includes Environmental Tobacco Smoke, click here. To access the most
recent NIOSH Current Intelligence Bulletin 54: Environmental Tobacco Smoke
in the Workplace (Lung Cancer and Other Health Effects) which was published in 1991 (NIOSH Publication Number
91-108), and which contains information on the carcinogenic effects of
environmental tobacco smoke and the possible association between ETS exposure
and an increased risk of heart disease, click here.
SCIENTIFIC STUDIES, REPORTS & FACT SHEETS ON THE HEALTH
EFFECTS OF SECONDHAND SMOKE
Major
Study: Passive Smoking and Risk of Coronary Heart Disease & Stroke
On
June 30, 2004, a landmark study published in the British Medical Journal found that exposure to secondhand smoke is even more
dangerous than previously thought and increases the risk of heart disease among
non-smokers by as much as 60 percent. This study provides the most compelling
evidence yet that secondhand smoke causes heart disease. It is the first study
to show a direct physical link between secondhand smoke exposure and an
increased risk of heart disease. The study, conducted over 20 years by
researchers at St. George's Hospital Medical School in London, is particularly
important because it measured exposure to secondhand smoke from all sources --
including in bars, restaurants, and other workplaces, as well as in the home --
based on blood levels of a nicotine byproduct called cotinine. They found that
high blood cotinine levels were associated with a 50 to 60 percent higher risk
of coronary heart disease. Previous studies had estimated increased risk at 25
to 30 percent. The study is one of the few that has sought to account for all
sources of exposure to secondhand smoke, not just home exposure. To access the
full study, click above.
New study
shows indoor air is 82% cleaner in smoke-free cities
On
May 20, 2004 the Campaign for Tobacco-Free Kids released results of a study
comparing indoor air quality in bars and restaurants of three cities with
smoke-free laws (New York City, Buffalo and Los Angeles) and four cities
without smoke-free laws (Washington, DC, Philadelphia, Baltimore and Hoboken,
NJ). The study found that air pollution levels were 82 percent lower on average
in venues required by law to be smoke-free. According to the researchers at the
Roswell Park Cancer Institute in Buffalo, this study is the largest of its type
ever conducted to measure the impact of smoke-free laws on the indoor air
quality of restaurants and bars. It provides powerful evidence that smoke-free
laws protect workers and patrons from the harmful air pollutants in secondhand
smoke and shows why every community and every state should enact such laws
covering all indoor workplaces and public places. The 33-page study can be
accessed by clicking above.
On
April 5, 2004, a new study was posted on the British Medical Journal (BMJ) web
site to report that the implementation of a comprehensive local clean indoor
air ordinance in Helena, Montana, may have resulted in a rapid reduction in
heart attacks. The study, which will be published in the April 24 print BMJ,
found hospital admissions for acute myocardial infarction (AMI) declined by
about 40% during the 6 months the ordinance was in effect and rebounded after
the ordinance was suspended. A commentary on the study, provided by Dr.
Terry Pechacek, Associate Director of Science in CDC's Office on Smoking and
Health (OSH), and co-author Stephen Babb, a CDC health education specialist, also
to be published in the April 24 issue, discusses the biological plausibility of
these types of findings. The
commentary is available on the BMJ web site by clicking above. To access the
Helena study, see note directly below.
The
following is from an ANR press release: A new study posted April 5, 2004 on the
British Medical Journal website
shows that the health benefits of a comprehensive smokefree workplace law may
be much more immediate than previously thought, resulting in a decline of 40%
in the number of heart attacks. The study, authored by Richard P. Sargent,
MD, Robert M. Shepard, MD, and Stanton A. Glantz, PhD, looked at the number of
hospital admissions in Helena, Montana for acute myocardial infarctions (AMI)
during a sixth month period; compared those numbers to the same time period in
the previous four years, and looked at figures for the surrounding area not
affected by the smokefree law. The doctors found a 40% drop in admissions for
heart attacks from people living or working in Helena -- where a smokefree
ordinance was in effect -- and no change for people living further away. According to Dr. Glantz, "This is not the first
study to find a link between long term exposure to secondhand smoke and heart
attacks. There is a mountain of evidence that this connection exists. It is,
however, the first study to show the rapid community level benefits of a
smokefree policy. This study shows that a comprehensive indoor smoke-free law
reduces heart attacks immediately." One year after Dr. Sargent presented
the Helena Heart Study findings at the Annual Scientific Sessions of the
American College of Cardiology in Chicago in April, 2003, the British Medical
Journal, one of the most prominent peer-reviewed medical journals in the world,
is publishing the dramatic results. The journal article points out that even 30
minutes of exposure to secondhand smoke increases blood platelet
"stickiness," which can lead to blood clots. In addition, arteries
narrow after exposure to secondhand smoke, so smaller clots cause more damage,
and there is an increase in heart rhythm problems associated with heart
attacks. According to Cynthia Hallett, Executive Director of Americans for
Nonsmokers' Rights (ANR), "The bottom line is simple. Secondhand smoke
kills. This study validates that there are important and immediate
community-level health benefits to smoke-free workplace policies. All
nonsmokers deserve to breathe smoke-free air in enclosed workplaces and public
places." To access the full study, in pdf format, click above. For the
full ANR press release, click here.
Mortality
among "never smokers" living with smokers: two cohort studies, 1981-4
and 1996-9
The
study of the above title was published in the April 5, 2004 issue of the British
Medical Journal. The study examined
the association between secondhand smoke and mortality. The authors found that
adults who had never smoked and who lived with smokers had about 15% higher
mortality than never smokers living in a smoke-free household. This is another
very important study of the effects of secondhand smoke. Click above to access
the full study, in pdf format.
The
December 21, 2001 issue of Lancet contains
one of the largest studies of passive smoking. The study found that secondhand
smoke increases the risk of asthma and other respiratory problems in
non-smokers and is widespread in many countries, particularly in the workplace.
The study analyzed data on nearly 8,000 people in the United States, 16 European
countries, Australia and New Zealand. The study showed the proportion of people
who regard themselves as exposed to passive smoking varied from a high of 53
percent in Spain to less than three percent in Sweden. Dr. Christer Janson said
his colleagues analyzed information on nearly 8,000 men and women questioned
about their exposure to secondhand smoke and given a physical examination to
determine its impact on their health. In 12 of the 36 centers included in the
study more than half of those questioned reported being exposed to secondhand
smoke. The prevalence of passive smoking was directly related to the level of
smoking in each country. They found passive smoking had a strong effect on
asthma and respiratory symptoms such as breathlessness, chest tightness and
lung function in adults. "It (passive smoking) has been described in many
other publications in children but it hasn't been studied to that extent in
adults," said Janson. Regulations and the prevalence of smoking were the
biggest factors determining the number of people exposed to secondhand smoke.
Italy, Spain and other southern and central European countries, which have a
higher prevalence of smokers, have more passive smokers while Scandinavian
nations, Australia, New Zealand and the United States had the least. "We
found a positive association between passive smoking in the workplace and
current asthma," the researchers said. "Decreasing involuntary
exposure to tobacco smoke in the community, especially in workplaces, is likely
to improve respiratory health." Click above to access the full text of the
study. You will need to be a registered user or an activated subscriber to The
Lancet . Becoming a registered user
of most major online journals allows free access to past issues six or twelve months
old and older.
Nicotine
& the Modern Lung Cancer Epidemic: The True Story
This
presentation by Clifford Douglas, Esq., legal consultant to the Smoke-Free
Environments Law Project, was given on November 9, 2000 at the Michigan
Tobacco-Free Institute. The presentation examined the ways in which the tobacco
industry has utilized the addictive nature of nicotine to hook smokers on this
deadly product and keep them hooked. The presentation provides, in a highly
interesting manner, a historical look at what the tobacco industry knew about
nicotine and how they tried to keep most of this secret; the result has been
that 9 out of 10 lung cancer deaths are due to the use of this addictive product.
Study
Finds Secondhand Smoke Kills 150 Hong Kong Food Service Workers Annually
On
May 15, 2001 the Hong Kong Council on Smoking & Health (COSH) released the
results of a very significant study which examined the effects of secondhand
smoke exposure among food service workers in Hong Kong. The study -- which
involved interviews and urine samples to detect cotonine, a marker for
secondhand smoke -- estimated that secondhand smoke kills about 150 food
service workers annually in Hong Kong. The study found that food service
workers had 5 1/2 times more cotonine in their urine than a control group of
nonsmokers working in smoke-free settings. Two articles have been released by
COSH based on this study, as follows: one article is by James Repace, titled Preliminary
Analysis of Dose, Exposure, and Risk for 104 Hong Kong Catering Workers Exposed
to Second Hand Smoke at Work Only, which
may be accessed here; and
an article by Hedley, McGhee, Repace, et al titled Second-hand Smoke
Exposures and Passive Smoking in Non-Smoking Catering Workers in Hong Kong: the
Combined Risks for Heart Disease and Cancer, which may be accessed here. Click above for a
Hong Kong news article on the study. Click here for Hong Kong Council on Smoking
& Health site which also has the texts of the articles and related
information.
Composition of
Cigarettes & Smoke: What Goes In? What Comes Out?
This
is a link to the ASH-Great Britain site which provides information and
additional links to a treasure trove of information on the ingredients and
additives in cigarettes, and the composition and constituents in tobacco smoke.
This site provides a simple explanation of the nature and composition of secondhand
smoke, as well as links to many of the scientific reports and analyses of
secondhand smoke. The site is a very valuable, one-stop resource.
Epidemiological
Basis for an Occupational & Environmental Policy on ETS
This
July 30, 2000 position statement and supporting analysis of the American
College of Occupational & Environmental Medicine (ACOEM) sets forth the
compelling evidence that secondhand smoke is a serious danger in the workplace.
The ACOEM states that "implementation of policies to prevent workplace ETS
can be highly effective, entailing low costs and yielding primary and secondary
benefits to employers and employees. ACOEM strongly supports an increase in the
scope and effectiveness of policies and efforts that protect against exposure
to ETS in the workplace and elsewhere ..., including public spaces such as
bars, casinos, restaurants, schools, daycare centers, and public
transportation."
Health
Hazards of Secondhand Smoke in the Workplace
This
August 9, 2000 study in the Journal of the American Medical Association
(JAMA) titled "Environmental
Tobacco Smoke Exposure Among Police Officers in Hong Kong" provides strong
new evidence of the dangers of secondhand smoke to workers on their job. The
study surveyed almost 4,500 male and over 700 female police officers in Hong
Kong who were never smokers; it found that 80% were exposed to secondhand smoke
in the workplace, and that significant associations existed between this
exposure and respiratory problems in both men and women. The study states that
the findings demonstrate a clear need for bans on smoking in the workplace.
Click above to access the full text of the study. You will need to be a
registered user or an activated subscriber to JAMA. Becoming a registered user of most major online
journals allows free access to past issues six or twelve months old and older.
Can Ventilation Systems Control
Secondhand Smoke in the Hospitality Industry?
This
detailed report by noted secondhand smoke expert James Repace examines the
question of whether traditional mechanical ventilation systems or new
displacement ventilation can reduce secondhand smoke levels to the point that
they are safe for workers or patrons in hospitality venues. He concludes that
they cannot, and that the only viable control measure continues to be total
smoking bans. (This 56 page report is in pdf format.)
Fact Sheet on
Secondhand Smoke
This
excellent analysis by Repace, Kawachi & Glantz is called a Fact Sheet, but
is much more than that. It provides a concise, but highly authoritative review
of the health issues associated with secondhand smoke, including the hazards
posed by exposure to secondhand smoke, the ingredients in ETS, as well as
information on smoke-free restaurant laws and the impact of these laws on the
economic viability of restaurants
ETS Report
from Johns Hopkins School of Public Health
This
is a comprehensive 1999 review, by Samet & Wang, of findings on the
respiratory and other health effects of ETS. The article reviews many reports
issued in recent years which examined ETS in relation to cardiovascular
diseases, asthma and ear disease in children, and sudden infant death syndrome;
it includes an extensive list of references on ETS.
The
Accumulated Evidence on Lung Cancer & ETS
This
highly regarded article by Hackshaw, Law & Wald in the October 18, 1997
issue of the British Medical Journal analyzed 37 published epidemiological
studies of the risk of lung cancer in non-smokers who did and did not live with
a smoker. The risk estimate was compared with that the risk in smokers using 7
studies. The analysis concluded that there is compelling evidence that exposure
to ETS is a cause of lung cancer.
ETS
Exposure & Ischaemic Heart Disease: An Evaluation of the Evidence
This
October 18, 1997 article by Law, Morris & Wald in the British Medical
Journal analyzed 19 published studies of ischaemic heart disease and concluded
that there is no satisfactory alternative interpretation of the evidence
reviewed than that environmental exposure to tobacco smoke causes an increase
in risk of ischaemic heart disease of the order of 25%. In proportionate terms
this is of similar magnitude to the effects of exposure to environmental
tobacco smoke on lung cancer, but the number of excess deaths from heart
disease will be far greater because heart disease is so much more common than
lung cancer in non-smokers. The effect of ETS is not trivial. It is a serious
environmental hazard, and one that is easily avoided. The evidence on ischaemic
heart disease warrants further action in preventing smoking in public buildings
and enclosed working environments. The hazard in the home requires greater
public education so that smokers recognize the risk to which they expose
members of their family. It is also important that clinicians advise that
families of patients with known coronary artery disease do not smoke in their
presence.
This
paper from the National Clearinghouse on Tobacco and Health in Canada provides
a concise overview of the health effects of ETS.
Exposure to
ETS: Identifying & Protecting Those at Risk
This
editorial by Dr. Ronald Davis was published in the December 9, 1998 issue of
the Journal of the American Medical Association. The editorial reviews the
current research on ETS and examines which workers are at great risk from
secondhand smoke and remedies that are available. You will need to be a
registered user or an activated subscriber to JAMA. Becoming a registered user of most major online
journals allows free access to past issues six or twelve months old and older.
Bartenders'
Respiratory Health After Establishment of Smoke-Free Bars and Taverns
This
article by Eisner, et al in the December 9, 1988 issue of the Journal of the
American Medical Association studied the respiratory health of bartenders
before and after the prohibition of smoking in all bars and taverns in
California. This seminal study found that the establishment of smoke-free bars
and taverns was associated with a rapid improvement in the respiratory health
of the bartenders.
This
Canadian National Clearinghouse on Tobacco and Health site provides links to a
variety of Fact Sheets on ETS, including ones on: ETS and Your Heart; ETS at
Work; ETS and Your Lungs; ETS and Public Places; etc.
Secondhand
Smoke & the Tobacco Industry
This
Americans for Nonsmokers' Rights site provides a brief synopsis of the
scientific reports on the dangers of ETS, and a listing of tobacco industry
attacks on scientific reports concerning ETS.
Smoke-Free Environments Law Project
The Center for Social Gerontology
2307 Shelby Avenue
Ann Arbor, MI 48103
734.665.1126
734.665.2071 Fax
SFELP@tcsg.org