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• Secondhand smoke exposure worse for toddlers, obese children 

Toddlers and obese children suffer more than other youth when exposed to secondhand smoke, according to research presented at the American Heart Association's Scientific Sessions 2009.

"Secondhand smoke in children is not just bad for respiratory issues, as has been previously described by other researchers," said John Anthony Bauer, Ph.D., the study's senior co-author and principal investigator at Nationwide Children's Hospital & Research Institute at Ohio State University in Columbus. "Our data support the view that cardiovascular effects of secondhand smoke in children are important, particularly for the very young and those who are obese. We had not investigated the impact of obesity in previous studies."

Bauer and colleagues recruited American boys and girls, including 52 toddlers (ages 2 to 5 years) and 107 adolescents (ages 9 to 18 years). The study included black, white and Hispanic children, including obese toddlers and adolescents.

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• Exposure to secondhand smoke increases risk for Type 2 diabetes 

Chronic secondhand smoke exposure significantly increases the risk for Type 2 diabetes, show results from a study of Greek and Cypriot elderly men and women.

“While active smoking is strongly related to the development of diabetes mellitus, the role of exposure to secondhand smoke in the development of diabetes mellitus is unclear,” write Demosthenes Panagiotakos (Harokopio University, Athens, Greece) and colleagues in the journal Diabetic Medicine.

The researchers recruited 1190 elderly men and women aged 65 years or above from several Greek and Cypriot islands in the Mediterranean during 2005–2007.

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• Cigarettes harbor many pathogenic bacteria 

Cigarettes are "widely contaminated" with bacteria, including some known to cause disease in people, concludes a new international study conducted by a University of Maryland environmental health researcher and microbial ecologists at the Ecole Centrale de Lyon in France.

The research team describes the study as the first to show that "cigarettes themselves could be the direct source of exposure to a wide array of potentially pathogenic microbes among smokers and other people exposed to secondhand smoke." Still, the researchers caution that the public health implications are unclear and urge further research.

"We were quite surprised to identify such a wide variety of human bacterial pathogens in these products," says lead researcher Amy R. Sapkota, an assistant professor in the University of Maryland's School of Public Health.

"The commercially-available cigarettes that we tested were chock full of bacteria, as we had hypothesized, but we didn't think we'd find so many that are infectious in humans," explains Sapkota, who holds a joint appointment with the University's Maryland Institute for Applied Environmental Health and the department of epidemiology and biostatistics.

"If these organisms can survive the smoking process -- and we believe they can -- then they could possibly go on to contribute to both infectious and chronic illnesses in both smokers and individuals who are exposed to environmental tobacco smoke," . . .

The study will appear in an upcoming edition of the journal Environmental Health Perspectives. . . .

Sapkota's team took a more holistic approach using DNA microarray analysis to estimate the so-called bacterial metagenome, the totality of bacterial genetic material present in the tested cigarettes.

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The commercially-available cigarettes that we tested were chock full of bacteria, as we had hypothesized, but we didn't think we'd find so many that are infectious in humans. If these organisms can survive the smoking process -- and we believe they can -- then they could possibly go on to contribute to both infectious and chronic illnesses in both smokers and individuals who are exposed to environmental tobacco smoke.
Lead researcher Amy R. Sapkota, an assistant professor in the University of Maryland's School of Public Health, on the study that will appear in an upcoming edition of the journal Environmental Health Perspectives.

• The science behind moving smoking bans outside  

Reflecting on the existing scientific research on second hand smoke exposure outdoors, William Saletan of Slate.com sifts through the most relevant points from two major studies on the subject (the 2006 California Air Resources Board study, and a 2007 study from Stanford). Among the findings: outdoors, second hand smoke levels vary widely and quickly, depend on the individual's distance from a smoker (farther than 6.5 feet or 2 meters, generally reduces exposure to "background" levels), are influenced by how confined the outdoor space is (if there are walls or fences), and the concentration of smokers in a given area. The data, Saletan concludes, point to the need for a measured approach for crafting policy to reduce second hand smoke exposure outdoors. He writes:

"If you want to argue for parkwide smoking bans based on asthma or on an analogy to noise pollution, go ahead and make that case. But let's not cloud that debate by invoking the general harm of secondhand smoke. Studies of secondhand smoke have indeed moved outdoors. Their findings support restrictions on lighting up within a few feet of other people. But they don't warrant more than that."

A new study published in the November issue of the Journal of Occupational and Environmental Hygiene may contribute to the debate. Researchers from the University of Georgia measured second hand smoke exposure among people sitting in the outdoor areas of bars and restaurants where indoor smoking was banned in the city of Athens, Georgia. . . .

generally speaking, hanging out in an outdoor smoking area exposes you to less second hand smoke than being in an indoor, confined space with smokers, and the more space you have between yourself and smokers, the lower levels of exposure you will have. So, this particular study doesn't ring the death knell for outdoor smoking. But, the researchers point out, wielding the official trump card of the public health argument:

Although the increment in cotinine concentrations and, thus, the [second hand smoke] exposure levels were relatively low at the sites of interest, the current view is that there is no level of personal exposure to [second hand smoke] that can be regarded as safe. This study demonstrates the ongoing exposure of nonsmokers to [second hand smoke] outside restaurants and bars, and the limitations of indoor smoking bans alone in protecting the public from exposure to [second hand smoke] outside these establishments.

In other words, the movement to ban smoking in outdoor spaces is here to stay.

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• Study raises concerns about outdoor second-hand smoke 

Indoor smoking bans have forced smokers at bars and restaurants onto outdoor patios, but a new University of Georgia study in collaboration with the Centers for Disease Control and Prevention suggests that these outdoor smoking areas might be creating a new health hazard.

The study, thought to be the first to assess levels of a nicotine byproduct known as cotinine in nonsmokers exposed to second-hand smoke outdoors, found levels up to 162 percent greater than in the control group. The results appear in the November issue of the Journal of Occupational and Environmental Hygiene.

"Indoor smoking bans have helped to create more of these outdoor environments where people are exposed to secondhand smoke," said study co-author Luke Naeher, associate professor in the UGA College of Public Health. "We know from our previous study that there are measurable airborne levels of secondhand smoke in these environments, and we know from this study that we can measure internal exposure.

"Secondhand smoke contains several known carcinogens and the current thinking is that there is no safe level of exposure," he added. "So the levels that we are seeing are a potential public health issue."

Athens-Clarke County, Ga., enacted an indoor smoking ban in 2005, providing Naeher and his colleagues and ideal environment for their study.

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• Study raises concerns about outdoor second-hand smoke 

Indoor smoking bans have forced smokers at bars and restaurants onto outdoor patios, but a new University of Georgia study in collaboration with the Centers for Disease Control and Prevention suggests that these outdoor smoking areas might be creating a new health hazard.

The study, thought to be the first to assess levels of a nicotine byproduct known as cotinine in nonsmokers exposed to second-hand smoke outdoors, found levels up to 162 percent greater than in the control group. The results appear in the November issue of the Journal of Occupational and Environmental Hygiene.

"Indoor smoking bans have helped to create more of these outdoor environments where people are exposed to secondhand smoke," said study co-author Luke Naeher, associate professor in the UGA College of Public Health. "We know from our previous study that there are measurable airborne levels of secondhand smoke in these environments, and we know from this study that we can measure internal exposure.

"Secondhand smoke contains several known carcinogens and the current thinking is that there is no safe level of exposure," he added. "So the levels that we are seeing are a potential public health issue."

Athens-Clarke County, Ga., enacted an indoor smoking ban in 2005, providing Naeher and his colleagues and ideal environment for their study.

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• Mumbai's women face secondhand smoke risks: Smokefree Mumbai  

Not unlike their contemporaries in other Asian cities, woman in metroes of India, including those in Mumbai run a significant risk of developing peripheral arterial disease (PAD) from secondhand smoke (SHS), an NGO Smokefree Mumbai has said in its report.

Presenting the report on Chinese women and SHS, published in the American Heart Association's Circulation (AHAC), today Smokefree Mumbai said the report found that SHS had a significant, negative impact on the health of Chinese women, who had never smoked, the risk which would, without doubt, equate to Indian women too.

The first of its kind report by the AHAC had revealed a link between exposure to SHS and an increased chance of suffering from coronary heart disease, stroke, and peripheral arterial disease (PAD). . . .

''While 97 per cent Mumbaites have voted in favour of smoke-free environment, the ramification of the ban on smoking in public on the women population, largely non-smokers, may be found as reason for contemplation,'' observed the report.

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• TIMOTHY ANDERSON, Plaintiff-Appellee vs RACHEAL ANDERSON nka HILL, Defendant-Appellant (PDF) 

{¶1} Defendant-appellant, Racheal Anderson nka Hill, appeals a decision of the Warren County Common Pleas Court, Domestic Relations Division, regarding custody and parenting time matters involving her daughter. For the reasons set forth below, we affirm the decision of the trial court. . . .

On April 3, 2008, Marilyn moved the court to modify Racheal's parenting time with Victoria, and further moved the court for an order prohibiting all parties from smoking cigarettes in Victoria's presence. Marilyn argued that Victoria had expressed concerns, fears and reluctance over spending time with her mother, and had returned home from parenting time smelling of cigarette smoke as a result of Racheal smoking in her home and car. Marilyn also requested that a guardian ad litem be appointed for Victoria. . . .

In her third assignment of error, Racheal challenges the trial court's imposition of a no-smoking ban upon the parties. Specifically, she argues that there was no evidence before the court that Victoria suffered from any health problems or had an increased sensitivity to smoke, and she contends that there must be some evidence that a child suffers physical harm before the court can restrict a parent from engaging in a lawful activity. Racheal also points to the fact that the smoking ban is not limited to the parties' homes or to the parties themselves, and argues that the ban has effectively restricted the places where she can take Victoria.

{¶31} The trial court adopted the magistrate's finding that although there was no evidence presented to indicate that Victoria has any health problems or an increased sensitivity to cigarette smoke, it was not in Victoria's best interest to be exposed to such an activity. Indeed, other Ohio courts have made reference to the "avalanche of authoritative scientific studies" which indicate that "secondhand smoke constitutes a real and substantial danger to children because it causes and aggravates serious diseases in children, which danger is both a 'relevant factor' and a 'physical health factor'" that a trial court is required to consider in making a best interest determination under R.C. 3109.04(F). In Day, the Fifth District Court of Appeals found no abuse of discretion in the trial court's imposition of a no-smoking ban, noting that the Ohio Supreme Court has recognized conclusions made by the United States Surgeon General, as well as other health agencies, that "secondhand smoke impairs the respiratory health of thousands of young children." Id., quoting D.A.B.E., Inc. v. Toledo-Lucas Cty. Bd. of Health . . . . Regardless of the condition of their health, secondhand smoke is considered a danger to all children.

{¶32} Based on the foregoing, Racheal has not shown that the trial court's decision to restrict Victoria's exposure to cigarette smoke was arbitrary, unconscionable, or unreasonable so as to constitute an abuse of its discretion.

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• State-Specific Secondhand Smoke Exposure and Current Cigarette Smoking Among Adults --- United States, 2008 

Secondhand smoke (SHS) causes immediate and long-term adverse health effects in nonsmoking adults and children, including heart disease and lung cancer, and SHS exposure occurs primarily in homes and workplaces (1). Smoke-free policies, including not allowing smoking anywhere inside the home (i.e., having a smoke-free home rule), are the best way to provide protection from exposure to SHS. To assess SHS exposure in homes and indoor workplaces and the prevalence of smoke-free home rules, CDC analyzed 2008 Behavioral Risk Factor Surveillance System (BRFSS) data from 11 states and the U.S. Virgin Islands (USVI). This report summarizes the results, which showed wide variation among states in exposure to SHS in homes (from 3.2% [Arizona] to 10.6% [West Virginia]) and indoor workplaces (from 6.0% [Tennessee] to 17.3% [USVI]). The majority of persons surveyed in the 11 states and USVI reported having smoke-free home rules (from 68.8% [West Virginia] to 85.7% [USVI]). This report also provides the 2008 results for CDC's annual BRFSS-based state-specific estimates of current smoking in 50 states, the District of Columbia (DC), and three territories (Guam, Puerto Rico, and USVI). As in previous years, the results showed substantial variation in self-reported cigarette smoking prevalence (range: 6.5%--27.4%; median for 50 states and DC = 18.4%). Additional legislation is needed to increase the number of smoke-free workplaces and other public places. Health-care providers should continue to encourage persons to make their homes completely smoke-free.

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• Study Links Decline in Heart Attacks to Smoking Bans 

A Mississippi State study released Monday [Nov. 9] shows a 27 percent decrease in heart attacks among Starkville residents since the city passed a smoking ban in 2006.

Researchers associated with the university report also are recommending a statewide public ban on smoking.

The study by Robert McMillen and Dr. Robert Collins shows fewer heart attacks being treated at the Oktibbeha County Hospital. It focused on Starkville residents in the three-year span after the ban became law, compared to three years prior.

McMillen is an assistant professor in the psychology department and researcher at MSU's nationally recognized Social Science Research Center; Collins is director of University Health Services.

Their findings are part of a larger SSRC evaluation of Mississippi communities that passed smoking bans in recent years. McMillen said the data shows Starkville benefitting medically from the smoking ban.

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• Roll your own smokes popular but no safer, research finds  

The number of tobacco smokers currently in Thailand has reached 14.3 million, the latest Global Adult Tobacco Survey revealed yesterday.

Meanwhile, the Public Health Ministry is considering a proposal to the Finance Ministry to increase the tax level on hand-rolled cigarette products after finding over 7.4 million people smoke this style of cigarette. The remainder smoke manufactured cigarettes.

The Global Adult Tobacco Survey is a national household survey launched in February 2007.

Sixteen countries, home to more than half the world's smokers and bearing the highest tobacco use, were involved in the study: Bangladesh, Brazil, China, Egypt, India, Indonesia, Mexico, Pakistan, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay and Vietnam.

Thailand was the first country to complete and release its survey . . .

He said most cigarette manufacturers are now producing more smokeless cigarettes after noting an increasing trend in smokeless tobacco use among teenagers worldwide.

To reduce the number of hand-rolled cigarette smokers, Prakit has asked the government to increase the tax level on hand-rolled cigarette products and collect tax excise to 70 per cent of product price from the current rate.

Deputy Minister of Public Health Manit Nopamornbodee said he will consult with the Finance Ministry about increasing the tax level on hand-rolled cigarette products and ya nat - traditional medicine that contains hand-rolled cigarette products. . . .

Meanwhile, Thai Network Against Tabinfo Asia 2009, led by Dr Hatai Chitanont, has submitted an open letter to Deputy Finance Minister,Prasit Pattaraprasit asking him to withdraw from the tobacco industry event he is due to open on Wednesday at Impact Arena Moung Thontani Exhibition Centre.

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• Tobacco smoke linked with respiratory diseases 

Tobacco smoke is involved in uncontrolled asthma, a diminished response to anti-asthma drugs, rhinitis, nasal obstruction, and deregulation of the immune system according to an international expert at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Miami Beach, Fla.

Tobacco smoking has been mainly associated with chronic obstructive pulmonary disease (COPD), and is attributed to being one of the main reasons that COPD disease is the fourth leading cause of death in the United States.

"Recent studies have shown that smoking can be linked with other respiratory diseases such as asthma exacerbations and rhinitis," said Carlos Baena-Cagnani, M.D., faculty of medicine, at Catholic University of Cordoba in Argentina. "Both active and passive smoking has been shown to be involved in uncontrolled asthma and associated with asthma exacerbations in children and adolescents."

According to Dr. Baena-Cagnani, active smoking also causes changes in inflammation in asthma patients, diminishes their response to anti-asthma drugs, and has been found to induce nasal obstruction and decreased mucociliary clearance.

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• Court bans mom from smoking near child 

No smoking around your daughter.

That was a Warren County court's order to a mother last December - and now an appeals court has sided with that ruling, taking the unusual step of using "judicial notice" to conclude that second-hand smoke is a danger to a child.

In a decision that could apply to many other child-custody and visitation cases, the Ohio 12th District Court of Appeals in Middletown upheld the Warren court's decision forbidding anyone from smoking around Victoria Anderson, 9. Since she was a baby, she has lived with her great-grandmother in suburban Dayton, Ohio; she gets "parenting time" with her divorced mom and dad.

In April 2008, Victoria's paternal great-grandmother, Marilyn Anderson, objected to the child's mother, Racheal Hill, smoking around Victoria during visits. The child returned home "smelling of cigarette smoke as a result of Racheal smoking in her home and car," court records say.

Eight months later, the court ordered all parties to protect Victoria from second-hand smoke; the appeals court, which oversees an eight-county area, upheld the smoking ban Oct. 26.

Disputes over parental smoking have been cropping up in family-court cases nationwide, legal experts say, and the cases highlight two competing interests: A parent's right to smoke versus a child's right to breathe smoke-free air. . . .

the court did something unusual. It "took judicial notice" - without anyone presenting proof in court - of an "avalanche of authoritative scientific studies" that say second-hand smoking poses risks to children.

Taking judicial notice is fairly unusual, said Marianna Brown Bettman, a University of Cincinnati law professor.

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Taking judicial notice
The Ohio 12th District Court of Appeals "took judicial notice" of an "avalanche of authoritative scientific studies" that say second-hand smoking poses risks to children, and so ordered all parties to protect a 9-year-old from second-hand smoke.

• A review of human carcinogens—Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish 

New evidence continues to add to the extensive list of tobacco-related cancers (table); there is now sufficient evidence that tobacco smoking causes cancer of the colon3 and of the ovary.4 More than 150 epidemiological studies of tobacco smoking and breast cancer were reviewed. Large cohort studies5, 6 published since 20022 consistently show a small positive association (relative risks 1·1—1·3). Many chemicals in tobacco smoke cause mammary-gland tumours in animals, and these carcinogens are stored in breast adipose tissue in women; therefore, the Working Group concluded that there is limited evidence that tobacco smoking causes breast cancer. A causal link between parental smoking and childhood cancers has been established. Four recent studies showed that children born of parents who smoke (father, mother, or both, including the preconception period and pregnancy) are at significantly higher risk of hepatoblastoma, a rare embryonic cancer. The UK Childhood Cancer Study7 reported a relative risk of 1·86 for paternal smoking only and 2·02 for maternal smoking only, increasing to 4·74 (95% CI 1·68—13·35) when both parents smoke. For childhood leukaemia, a meta-analysis reported an association with paternal smoking before pregnancy (summary relative risk 1·12, 1·04—1·21).8 Second-hand smoke causes lung cancer.2 There is now limited evidence for an association with cancers of the larynx and the pharynx,9 whereas evidence for female breast cancer remains inconclusive. Since second-hand smoke contains most of the constituents of mainstream smoke, it might also be associated with other cancer sites. Many types of smokeless tobacco are marketed and all contain nicotine and nitrosamines. Hundreds of millions of people use smokeless tobacco, mainly in India and southeast Asia, but also in Sweden and the USA. Earlier findings showed a causal association between use of smokeless tobacco and cancers of the oral cavity and pancreas, and there is now sufficient evidence for cancer of the oesophagus.10 All of the forms of tobacco discussed above induce malignant tumours in laboratory animals.

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• SGA discusses smoking restrictions  

On Tuesday, the Student Government Association (SGA) considered a resolution on the policies proposed by Hopkins Kicks Butts that would restrict smoking on campus.

The resolution concluded that while the SGA supports efforts to promote the hazards of secondhand smoke, evidence on how these proposals would provide positive health benefits needs to be provided.

Part of the Hopkins Kicks Butts (HKB) proposal would implement a campus-wide ban on tobacco products, which would be enforced by peer-policing and a $15 ban per violation. The student organization has also called for smoking to be restricted to 50-foot zones.

"The public health objective says that smoking is harmful. What [this group] proposed is not practical," freshman class president Wyatt Larkin said.

He suggested that policymakers should determine if smoking is a threat to student health, rather than relying on the claims made by the HKB Web site, which Larkin said, "don't really add up." . . .

The SGA concluded the meeting with a motion to table the proposal until next week's meeting, which is scheduled to be in Mason Hall at 7 p.m.

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