NY TIMES CITES ASH ON SECONDHAND SMOKE [05/21]

The study reported yesterday about the grave dangers of exposure to secondhand tobacco smoke received widespread publicity.

Below are excerpts from one article, this from the New York Times:

STUDY FINDS SECONDHAND SMOKE DOUBLES RISK OF HEART DISEASE By DENISE GRADY

Secondhand cigarette smoke is more dangerous than previously thought, Harvard researchers are reporting today in a study with broad implications for public health policy and probable direct impact on at least one major lawsuit.

The 10-year study, which tracked more than 32,000 healthy women who never smoked, has found that regular exposure to other peoples' smoking at home or work almost doubled the risk of heart disease.

Many earlier studies have linked secondhand smoke to heart disease, but the new findings show the biggest increase in risk ever reported, and the researchers say that it applies equally to men and women.

The results mean that "there may be up to 50,000 Americans dying of heart attacks from passive smoking each year," said Dr. Ichiro Kawachi, an assistant professor of health and social behavior at the Harvard School of Public Health and the lead author of the study, which was published in the journal Circulation.

By contrast, lung cancer deaths from passive smoking are estimated to be far fewer, at 3,000 to 4,000 a year. Because heart disease is much more common than lung cancer, even a small increase in risk can cause many deaths.

"This is a very important study," said Dr. Stanton A. Glantz, a professor of medicine at the University of California at San Francisco, who has done extensive research on passive smoking but who was not involved in the Harvard study. "It's exceptionally strong and from a very solid group." Dr. Glantz also praised the Harvard team for what he called its careful analysis of workplace exposure to smoke, which had rarely been done before.

"That's important because of the effort to create laws controlling smoking in the workplace," he said.

In studies of both people and animals, Dr. Glantz and other researchers have identified several ways in which the chemicals in secondhand smoke can contribute to heart disease. Besides reducing a person's oxygen supply, the substances damage arteries, lower levels of the beneficial form of cholesterol known as HDL and increase the tendency of blood platelets to stick to one another and form clots that can trigger a heart attack. A study last year of healthy teen-agers and adults exposed to passive smoking for an hour or more a day detected artery damage. The higher the exposure was, the greater the damage.

"I think it could have very profound implications legally," said John Banzhaf, a law professor at George Washington University and executive director of Action on Smoking and Health, an antismoking group. "We now have proof which will meet the legal threshold requirement. In an ordinary civil suit, you have to prove something by what we call a preponderance of evidence, which means it's more probable than not."

The doubling of risk shown in today's study satisfied that requirement, Mr. Banzhaf said, adding, "You're right in that striking range with regard to the quantum of proof which we need."

Because passive smoke can cause heart problems more quickly than it causes lung cancer, Mr. Banzhaf said, it will be easier to prove the connection to juries.

The study may also affect negotiations between Northwest Airlines and its flight attendants. The airline still allows smoking on many of its flights to Japan and has stated that it will continue to even after other American carriers ban smoking on those routes in July.

Flight attendants have protested the decision, but a spokesman for Northwest, John Austin, said the airline would maintain a smoking section because its major competitor on those flights, Japan Air Lines, permitted smoking. But he added that Northwest's management had not yet seen the Harvard study. "It'll certainly factor in," he said. "But it's hard to say what the impact will be."

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