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. The team recruited 20 non-smoking adults and placed them in one of three environments: outside bars, outside restaurants and, for the control group, outside the UGA main library. Immediately before and after the six-hour study period, the volunteers gave a saliva sample that was tested for levels of cotinine, a byproduct of nicotine and a commonly used marker of tobacco exposure.

The team found an average increase in cotinine of 162 percent for the volunteers stationed at outdoor seating and standing areas at bars, a 102 percent increase for those outside of restaurants and a 16 percent increase for the control group near the library.

Naeher acknowledges that an exposure of six-hours is greater than what an average patron would experience but said that employees can be exposed for even longer periods.

“Anyone who works in that environment—waitresses, waiters or bouncers—may be there for up to six hours or longer,” Naeher said. “Across the country, a large number of people are occupationally exposed to second-hand smoke in this way.”

Studies that measured health outcomes following indoor smoking bans have credited the bans with lowering rates of heart attacks and respiratory illness, but Naeher said that the health impacts of outdoor second-hand smoke are still unknown.

In Naeher’s study, cotinine levels in the volunteers at the bar setting saw their levels increase from an average pre-exposure level of 0.069 ng/ml (nanograms per milliliter) to an average post-exposure level of 0.182 ng/ml. The maximum value observed, however, was 0.959 ng/ml. To put that number into context, a widely cited study has determined that an average cotinine level of 0.4 ng/ml increases lung cancer deaths by 1 for every 1,000 people and increases heart disease deaths by 1 for every 100 people.

Still, the researchers caution that it’s too early to draw policy conclusions from their findings. Cotinine is a marker of exposure to tobacco, Naeher said, but is not a carcinogen. The team is currently planning a study that would measure levels of a molecule known as NNAL, which is a marker of tobacco exposure and a known carcinogen, in people exposed to second-hand smoke outdoors.

“Our study suggests that there is reason to be concerned about second-hand smoke levels outdoors,” said study co-author Gideon St. Helen, who is pursuing his Ph.D. through the university’s Interdisciplinary Toxicology Program, “and our findings are an incentive for us to do further studies to see what the effects of those levels are.”

The study was funded by the Northeast (Georgia) Health District, the Athens (Georgia) Community Wellness Council and the Athens Tobacco Prevention Coalition.

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And Still the Smoke Is Thick..

TT Note: Guess the smoke will stay pretty thick over this burning issue. To me, it makes sense that a cigarette with no carcinogens and no secondhand smoke could be a very big boost for the family of someone who is a heavy smoker and who has been unable to quit. But what do I know. I'm only the asthmatic child of a heavy smoker who didn't know he was destroying my health with his habit. Did he quit? You bet. One week before his death.

Are E-Cigarettes Becoming a Victim of Friendly Fire or Vicious Assault From Special Interest Groups?

/PRNewswire/ -- While e-cigarettes have no known carcinogens and offer the benefit of no secondhand or sidestream smoke, some say that the products have been falling victim to friendly fire in the media. While the e-cigarette manufacturers and retailers believe they are on the same side of health organizations who want people to stop using tobacco, some anti-smoking campaigns are hostile to the idea.

Cheryl Healton, President and CEO of the American Legacy Foundation, is concerned that the product could be used to slow down the quitting process.

The American Legacy Foundation states on its website:

"We have seen no studies regarding whether e-cigarettes actually help smokers quit or, instead, delay cessation attempts by providing smokers with a way to continue their smoking behaviors when they cannot smoke a tobacco product."

With four prominent politicians on the board of directors, ranging from state attorney generals to senators and one who was named to World Pharmaceutical Frontiers' first "Pharma 40" list, it could easily be understood how this could be more of a political agenda than in the best interests of smokers and the public of the United States.

Even amid all of this, e-cigarettes are still rolling out to the public. Demand seems to be growing by the day, no matter what type of negative campaign comes along, suggesting that the public seems to be making up their own minds on the matter. After a recent spot on The Today Show concerning e-cigarettes, sales skyrocketed.

"Our sales shot up 100%," says Kyle Newton of EcigarettesChoice.com. "We're working harder every day to keep up with growing demand... people are elated that we're able to offer these products. I lost my mom to tobacco-related lung cancer, so this is an extremely personal issue for me... I wish they had been available for her."

And Kyle isn't alone in this personal quest. A quick search on blogs and forums for e-cigarette related information reveals a plethora of comments that support the product and an overwhelming displeasure of the FDA and special interest health groups' treatment of these products.

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