Epidemiology of environmental tobacco smoke exposure

Abstract

The health hazards due to exposure to environmental tobacco smoke (ETS) are increasingly established. ETS contains thousands of chemicals including 43 known carcinogens. One of the most important known health effects of ETS exposure is lung cancer in non-smokers, based on epidemiologic evidence and knowledge of the uptake and metabolism of ETS. Epidemiologic studies need to carefully take into account confounding and potential errors in exposure assessment. More research is needed to understand the genetic factors that influence ETS-induced lung cancer. Studies of the patterns of ETS exposure suggest higher rates of exposure in people employed as blue collar workers, in service occupations, earning lower incomes, and among the less educated. Certain racial/ethnic groups (e.g. Blacks, American Indians) may be at higher risk of ETS exposure. Despite substantial progress in protecting individuals from ETS exposure, additional efforts are needed in improving and enforcing policies to reduce exposure.

Multiplicity of abnormal promoter methylation in lung adenocarcinomas from smokers and never smokers

“…For example, twice as much nicotine is emitted in ETS as in mainstream smoke and the carcinogen 4-aminobiphenyl is enriched approximatel 30-fold in ETS. 30 Precedence exists for targeting of genes inactivated by promoter methylation in the never smoker. Our previous studies on methylation of MGMT and estrogen receptor ␣ revealed that both genes were inactivated at prevalences significantly greater in AdCs from never smokers than in smokers.…”

Developmental effects of exposure to environmental tobacco smoke and material hardship among inner-city children

“…Recent evidence suggests that such toxic exposures frequently occur in the context of multiple social disadvantages, many of which also impair child health and wellbeing [34,93]. Exposures to environmental tobacco smoke (ETS) and polycyclic aromatic hydrocarbons (PAH), in particular, are high among low-income, urban and minority populations, both because of the uneven distribution of outdoor pollution sources [19,95] and the higher smoking rates in these populations [16,36,73,90,94]. Across the United States, 10 million children under the age of 6 years are exposed to residential ETS [1], including exposures in the homes of relatives and caregivers [40].…”

Nongynecologic Cytology Practice Guideline

“…59 There is also an increased risk associated with secondary smoke, or "passive smoking." [103][104][105][106] It is estimated that 87% of lung cancers occur in tobacco smokers. 107 The risk pertains to all major types of lung cancer, particularly squamous and small cell types, which rarely occur in patients who have never smoked, and also adenocarcinomas, although they are less strongly associated with smoking.…”