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WHELAN: Surgeon General's Report Blows Smoke  

Facts:

--The publications correctly note that secondhand smoke can be a public health hazard: children are particularly vulnerable. Parental smoking increases the risk of sudden infant death syndrome and middle-ear diseases including acute and recurrent otitis media and chronic middle-ear effusion. ETS can trigger asthma, coughing, and breathlessness in exposed kids and can retard lung growth and pulmonary function. There is evidence in adults that it can cause nasal irritation (not to mention be intensely annoying).

--The SG report is on target in that it systematically dismisses (or says there is insufficient evidence) for many of the oft-claimed hazards of ETS . . .

--The most significant and questionable conclusion of both reports is that ETS causes lung cancer and cardiovascular disease in nonsmokers. The SG argues that ETS increases a nonsmoker's risk of heart disease by 30%, causing 46,000 premature deaths annually. Similarly, ETS allegedly increases the risk of lung cancer 20-30%, causing 3,000 premature deaths from this cause. . . .

That brings us to the most important concepts of all: dose and length of exposure. Both the Surgeon General's and the CDC report completely omit any reference to these critical variables. The CDC motto here is "It hurts you; it doesn't take much; it doesn't take long," and they note that "even a little (ETS) can be dangerous." The SG goes even further, with this totally outrageous statement: "the scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke." This leaves us with the clear impression that if we merely walk through a smoke-filled room, we have put our health in irreversible jeopardy.

These statements violate the basic tenet of toxicology: "only the dose makes the poison." What is most alarming here is that the top doctor in the land is communicating a message that anything that is harmful at high dose can be lethal at low dose -- when that is simply not true.

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