Secondhand smoke is accountable for 42,000
deaths annually to nonsmokers in the United States, including nearly 900
infants, according to a new UCSF study.
Altogether, annual
deaths from secondhand smoke represent nearly 600,000 years of potential
life lost – an average of 14.2 years per person – and $6.6 billion in
lost productivity, amounting to $158,000 per death, report the
researchers.
The study, which involved the first use of a
biomarker to gauge the physical and economic impacts of cigarette smoke,
revealed that secondhand smoke exposure disproportionately affects
African Americans, especially black infants.
The new research
reveals that despite public health efforts to reduce tobacco use,
secondhand smoke continues to take a grievous toll on nonsmokers.
The study was published in the American Journal of Public Health.
“In
general, fewer people are smoking and many have made lifestyle changes,
but our research shows that the impacts of secondhand smoke are
nonetheless very large,” said lead author Wendy Max, PhD, professor of
health economics at the UCSF School of Nursing and co-director of the
UCSF Institute for Health & Aging. “The availability of information
on biomarker-measured exposure allows us to more accurately assess the
impact of secondhand smoke exposure on health and productivity. The
impact is particularly great for communities of color.”
Exposure
to secondhand smoke is linked to a number of fatal illnesses including
heart and lung disease, as well as conditions affecting newborns such as
low birth weight and respiratory distress syndrome.
About a
decade ago, the federal Centers for Disease Control and Prevention –
using data from the California Environmental Protection Agency –
reported that 49,400 adults died annually as a result of secondhand
smoke exposure. Additionally, the CDC reported that 776 infants annually
died as a result of maternal exposure in utero.
Those widely-cited statistics relied on self-reporting to gauge the impact of secondhand smoke.
The
new study led by UCSF shows that the statistics on fatalities resulting
from for ischemic heart disease are 25 percent lower than previously
reported (34,000 deaths compared to 46,000), but nearly twice as high
for lung cancer deaths (7,333 deaths compared to 3,400). The new study
also shows higher infant mortality (863 deaths compared to 776).
The
researchers used serum cotinine – a biomarker which detects the
chemical consequences of exposure to tobacco smoke in the bloodstream -
to measure exposure to secondhand smoke. That measurement reflects
secondhand exposure in all settings, not just home or work, the authors
wrote.
The scientists gauged the economic implications – years
of potential life lost and the value of lost productivity – on different
racial and ethnic groups.
Mortality was measured in two
conditions for adults: lung cancer and ischemic heart disease; and four
conditions for infants: sudden infant death syndrome, low birth weight,
respiratory distress syndrome, and other respiratory conditions of
newborns.
Of the 42,000 total deaths resulting from secondhand
smoke, 80 percent were white, 13 percent were black, and 4 percent were
Hispanic. The vast majority of deaths were caused by ischemic heart
disease. Black babies accounted for a startling high 24 percent to 36
percent of all infant deaths from secondhand smoke exposure, the
researchers reported, although blacks represented only 13 percent of the
total U.S. population in 2006.
The value of lost productivity per death was highest among blacks ($238,000) and Hispanics ($193,000).
“Black
adults had significantly greater exposure rates than did whites in all
age groups,” the authors wrote. “The highest secondhand smoke exposure
was for black men aged 45 to 64 years, followed by black men age 20 to
44 years. Black women aged 20 to 44 years had a higher exposure rate
(62.3 percent) than did any other women.”
“Our study probably
under-estimates the true economic impact of secondhand smoke on
mortality,” said Max. “The toll is substantial, with communities of
color having the greatest losses. Interventions need to be designed to
reduce the health and economic burden of smoking on smokers and
nonsmokers alike, and on particularly vulnerable groups.”
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