Excerpt

This Surgeon General’s report returns to the topic of the health effects of involuntary exposure to tobacco smoke. The last comprehensive review of this evidence by the Department of Health and Human Services (DHHS) was in the 1986 Surgeon General’s report, The Health Consequences of Involuntary Smoking, published 20 years ago this year. This new report updates the evidence of the harmful effects of involuntary exposure to tobacco smoke. This large body of research findings is captured in an accompanying dynamic database that profiles key epidemiologic findings, and allows the evidence on health effects of exposure to tobacco smoke to be synthesized and updated (following the format of the 2004 report, The Health Consequences of Smoking). The database enables users to explore the data and studies supporting the conclusions in the report. The database is available on the Web site of the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/tobacco.

Contents

• Message from Michael O. Leavitt
• Foreword
• Preface from the Surgeon General, U.S. Department of Health and Human Services
• Acknowledgments
• 1. Introduction, Summary, and Conclusions
  • Introduction
  • Definitions and Terminology
  • Evidence Evaluation
  • Major Conclusions
  • Chapter Conclusions
  • Methodologic Issues
  • Tobacco Industry Activities
  • References
• 2. Toxicology of Secondhand Smoke
  • Introduction
  • Evidence of Carcinogenic Effects from Secondhand Smoke Exposure
  • Mechanisms of Respiratory Tract Injury and Disease Caused by Secondhand Smoke Exposure
  • Mechanisms of Secondhand Smoke Exposure and Heart Disease
  • Evidence Synthesis
  • Conclusions
  • Overall Implications
  • References
• 3. Assessment of Exposure to Secondhand Smoke
  • Introduction
  • Building Designs and Operations
  • Atmospheric Markers of Secondhand Smoke
  • Exposure Models
  • Biomarkers of Exposure to Secondhand Smoke
  • Conclusions
  • References
• 4. Prevalence of Exposure to Secondhand Smoke
  • Introduction
  • Methods
  • Metrics of Secondhand Smoke Exposure
  • Estimates of Exposure
  • Conclusions
  • Overall Implications
  • References
• 5. Reproductive and Developmental Effects from Exposure to Secondhand Smoke
  • Introduction
  • Conclusions of Previous Surgeon General’s Reports and Other Relevant Reports
  • Literature Search Methods
  • Critical Exposure Periods for Reproductive and Developmental Effects
  • Fertility
  • Pregnancy (Spontaneous Abortion and Perinatal Death)
  • Infant Deaths
  • Sudden Infant Death Syndrome
  • Preterm Delivery
  • Low Birth Weight
  • Congenital Malformations
  • Cognitive, Behavioral, and Physical Development
  • Childhood Cancer
  • Conclusions
  • Overall Implications
  • References
• 6. Respiratory Effects in Children from Exposure to Secondhand Smoke
  • Introduction
  • Mechanisms of Health Effects from Secondhand Tobacco Smoke
  • Methods Used to Review the Evidence
  • Lower Respiratory Illnesses in Infancy and Early Childhood
  • Middle Ear Disease and Adenotonsillectomy
  • Respiratory Symptoms and Prevalent Asthma in School-Age Children
  • Childhood Asthma Onset
  • Atopy
  • Lung Growth and Pulmonary Function
  • Conclusions
  • Overall Implications
  • References
• 7. Cancer Among Adults from Exposure to Secondhand Smoke
  • Introduction
  • Lung Cancer
  • Other Cancer Sites
  • Conclusions
  • Overall Implications
  • Appendix 7.1 Details of Recent Lung Cancer Studies
  • References
• 8. Cardiovascular Diseases from Exposure to Secondhand Smoke
  • Introduction
  • Coronary Heart Disease
  • Stroke
  • Subclinical Vascular Disease
  • Evidence Synthesis
  • Conclusions
  • Overall Implications
  • References
• 9. Respiratory Effects in Adults from Exposure to Secondhand Smoke
  • Introduction
  • Biologic Basis
  • Odor and Irritation
  • Respiratory Symptoms
  • Lung Function
  • Respiratory Diseases
  • Conclusions
  • Overall Implications
  • References
• 10. Control of Secondhand Smoke Exposure
  • Introduction
  • Historical Perspective
  • Attitudes and Beliefs About Secondhand Smoke
  • Policy Approaches
  • Technical Approaches
  • Conclusions
  • Overall Implications
  • References
• A Vision for the Future
• Appendix
• List of Abbreviations

Suggested citation:

U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.