2. Passive smoking Royal College of Physicians of London




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Title2. Passive smoking Royal College of Physicians of London
Date02.03.2013
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TypePresentations


2. Passive smoking

  • Royal College of Physicians of London

  • Tobacco Advisory Group


Passive smoking – what are the effects?

  • Fatal risks

    • Several hundred lung cancers (UK)
    • Several thousand heart disease cases
  • Non-fatal impacts

    • Lung function, cough, wheeze, phlegm
    • Asthma aggravation
  • Children

    • Sudden infant death, middle ear infection, lung disease
  • Unborn child

    • Spontaneous abortion, perinatal death, preterm birth, low birthweight


Passive smoking & lung cancer – Risk in non-smoking women living with smoker compared to non-smoker

  • “compelling confirmation” that passive smoke is a cause of lung cancer

  • Excess risk of lung cancer 24%

  • Corresponds to 100s of deaths in the UK annually



Passive smoking & heart disease – Risk in non-smokers living with smoker compared to non-smoker

  • Exposure to passive smoke increases risk of ischaemic heart disease by 25%

  • Equates to half the risk of smoking 20 cigarettes a day

  • No significant bias or confounding



Passive smoking & heart / circulatory disease

  • Dramatic non-linear effect

    • 1% of the smoke exposure, but half the heart disease risk of a 20/day smoker
  • 12,000 cases of heart disease annually (UK)

    • Though with some uncertainty
  • Increased risk of stroke

  • Suggested mechanism - platelet aggregation



Passive smoking & respiratory disease

  • Exposure delivers carcinogens to all parts of the respiratory tract

  • Associated with decreased lung function

  • 40 – 60% increase risk of aggravating symptoms of pre-existing asthma





Passive smoking & children

  • SIDS

  • Middle ear infection (“glue ear”)

  • Asthma

  • Bronchitis & pneumonia

  • Respiratory tract infection

  • Low birth weight

  • Meningococcal infections



Passive smoking & fetus

  • Smoking during pregnancy is a cause of:

  • Lower birth weight

  • Increased risk of stillbirth

  • 27% higher rate of spontaneous abortion (4300 per year)

  • Excess perinatal deaths due to maternal smoking = 420 pa in England & Wales



Passive smoking & other health impacts

  • Asthma

  • Eye irritation

  • Coughing

  • Nausea

  • Headaches

  • Unpleasant smell



Attitudes towards smoking



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