The two leading causes of preventable deaths in the United States are smoking and alcohol abuse. What's the third? The answer given by two medical researchers at UC San Francisco is a shocker. Statistician Stanton Glantz and cardiologist Dr. William Parmley say that passive smoking--the smoke that nonsmokers involuntarily inhale--now ranks as the third leading cause of avoidable fatal diseases.
In remarks to the World Conference on Lung Health in Boston, Glantz attributed 32,000 annual deaths from heart disease to second-hand smoke. The Environmental Protection Agency, meanwhile, reports that passive smoking causes 3,000 cases a year of usually fatal lung cancer. Preventable deaths from unwanted exposure to tobacco smoke thus exceed the combined toll of accidental deaths from falls, drowning, fire, choking and poisons.
The EPA is getting ready to declare environmental tobacco smoke a known carcinogen. But what Glantz and Parmley have also found is that passive smoking is responsible for at least 10 times as many deaths from heart disease as deaths from lung cancer. The risk appears to be especially great in the home. Glantz says the evidence from numerous studies indicates that nonsmokers who live with smokers have a 20% to 30% higher risk of dying from heart disease than do other nonsmokers.
Scientists are now beginning to understand exactly how smoking affects the heart, blood and arteries to produce increased risk of heart disease. According to Glantz, carbon monoxide in tobacco smoke binds with hemoglobin in the blood, reducing its capacity to carry vital oxygen. Smoking also reduces the ability of the heart's cells to convert oxygen to adenosine triphosphate, or ATP, a chemical that provides the heart with energy. Smokers' hearts are forced to work harder and less efficiently. What studies now indicate is that passive smoking produces similar harmful results. Those results can be measured; nonsmokers exposed to second-hand smoke are unable to exercise for the same length of time as nonsmokers who are not so exposed.
What's to be done? The government cannot, of course, set standards in the home to try to protect nonsmokers from harm by smokers. But stricter separation of smokers from nonsmokers in public places certainly can and should be enforced. At the same time, government can mount a continuing campaign in the schools and through public service announcements and the like to alert everyone to the perils of second-hand smoking. Smokers often insist on their "rights." But there is no right to make others sick unto death with second-hand smoke. It's become clearer than ever that smoking isn't simply a matter of self-destruction, but a public-health menace. The mortality statistics for tens of thousands of nonsmokers have put that conclusion beyond dispute.