4.1 Background
Show / hide chapter menu
It has been known since the early 1950s that active smoking is a cause of disease in smokers.1, 2 Conclusive evidence that the inhalation of other people's tobacco smoke can be harmful to health has accumulated more recently. Early indications that exposure to secondhand smoke causes respiratory illness in children were published in the 1970s,3-5 and studies demonstrating adverse effects on the health of adult non-smokers began to emerge in the following decade.6, 7
In the second half of the 1980s several major international reports were published that reviewed the scientific evidence about the health effects of secondhand smoke. The International Agency for Research on Cancer8, Australia's National Health and Medical Research Council,9 the US Surgeon General,10 the US National Research Council11 and the UK's Independent Scientific Committee on Smoking and Health12 were chief among the scientific organisations which issued landmark publications concluding that exposure to secondhand smoke was a cause of illness and death in non-smokers, from infancy through to adulthood. Subsequent reviews published by expert agencies have since strengthened and extended these findings.13-20 It is now well-established that secondhand smoke causes coronary heart disease and lung cancer in non-smoking adults, induces and exacerbates a range of mild to severe respiratory effects in infants, children and adults, and increases the risk of Sudden Infant Death Syndrome and a range of other serious health outcomes in young children.19, 20 Secondhand smoke is considered to be third among the leading causes of preventable death and disease in the USA, ranking behind active smoking and alcohol use.21, 22 At particular risk are the young, who lack control over their environment,19 and the socially disadvantaged, who are more likely to be exposed to secondhand smoke at home and elsewhere.20
There is no level of exposure to secondhand smoke that is free of risk.19, 20 Since Australians spend up to 90% of their time indoors,23 indoor air quality is an important public health issue. The awareness that secondhand smoke is dangerous makes smoking a safety issue in the workplace, in entertainment venues including hotels, casinos, restaurants and nightclubs, in vehicles and in the home. In some parts of Australia there are now restrictions on smoking in certain outdoor areas as well, such as alfresco dining areas, sporting and other entertainment venues and beaches. Regulations and policy concerning smokefree environments are discussed in Chapter 15.
The emergence of secondhand smoke as a public health issue has been a major public relations setback for the tobacco industry. Its traditional defence that smoking is a rightful expression of individual choice and personal freedom is seriously undermined when smoking is viewed through the prism of wider public health, implications for occupational health and safety and the right of non-smokers to breathe smokefree air. Not surprisingly, the industry has fought a bitter rearguard action against publicity concerning the health effects of secondhand smoke, endeavouring to downplay and obfuscate evidence about health consequences and to influence formation of policies on smoking through a number of means.20, 24-26 This is discussed further in Chapter 10.
Copyright © 2012 The Cancer Council. All rights reserved.