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Secondhand smoke is given off by a tobacco product that is burning and also includes the smoke exhaled by the person smoking. It contains more than 50 chemicals that are reported to cause cancer in animals or humans. People are exposed to second hand smoke in various settings for example in cars, homes, workplaces and public places for example restaurants, bars as well as recreational settings. In USA, most secondhand smoke is gotten from cigars, cigarettes, pipes as well as other numerous tobacco products.
Discussion
Secondhand smoke exposures are usually measured by testing the chemicals in the tobacco smoke as well as indoor air for the nicotine. Exposures can also be tested through measuring the levels of cotinine in the nonsmokers’ saliva, blood or urine. Cotinine, nicotine, carbon monoxide as well as other related chemicals have always been found in body fluids of the nonsmokers who are exposed to secondhand smoke. Among all the 4,000 chemicals which have been identified in tobacco smoke, around 250 are detrimental for example carbon monoxide, ammonia and hydrogen cyanide (National Toxicology Program, 2005).
Nicotine and cigarette smoke are among the most studied toxicants. When tobacco smoke is inhaled, nicotine enters the body and is absorbed into the bloodstream from the lungs (National Toxicology Program, 2005). Upon absorption, nicotine is broken down into cotinine, a metabolite which serves as the biomarker for ETS exposure in people who are non-smokers (National Toxicology Program, 2005). Cotinine reflects exposure to tobacco smoke for a period of at least two days. Some of the toxic chemicals found in secondhand tobacco smoke include benzene, arsenic, cadmium, ethylene oxide, nickel, vinyl chloride, nickel, polonium-210 among others. Formaldehyde, toluene and benzolpyrene are other toxic chemicals found in secondhand smoke which are suspected to cause cancer. There are various factors which affect the chemicals to be found in secondhand smoke. These include, the type of tobacco, the chemicals added to the tobacco, the method in which the tobacco product was smoked and the material in which the cigar or cigarette is wrapped in (National Cancer Institute, 2004).
Consumer exposure and vulnerability assessment
The US National Toxicology Program, The US Surgeon General, The Environmental Protection Agency and the International Agency for Research on Cancer have classified second hand smoke as a cancer-causing agent in humans (US Department of Health and Human Services, 2006). Secondhand smoke causes lung cancer in adults who do not smoke. It is estimated that up to 3000 lung cancer deaths occur due to secondhand smoking. The Surgeon General approximates that living with a smoker leads to an increased risk of developing lung cancer in non-smoker by about 20-30% (International Agency for Research on Cancer, 2002).
Secondhand smoke is usually associated with premature deaths and diseases in children as well as the nonsmoking adults. Exposures to the tobacco smoke usually irritate the airways and do have a harmful effect on the blood vessels and person’s heart. It also increases risks of heart diseases by approximately 25 to around 30% (Sergio, 2003, pp. 186). In USA, secondhand smoke causes around 46,000 heart diseases and deaths annually (Michael, 2006, pp. 40). Children who are exposed to tobacco smoke are also at increased risk of ear infections, sudden deaths, pneumonia, colds, bronchitis as well as asthma. It usually slows the growth of their lungs hence causing them to wheeze, cough and always feel breathless.
Risk assessment
There is basically no any safe level of exposures to smoke as even the low levels can be quite harmful. The only way in which the nonsmokers can be protected from smokers is to fully eliminate smoking in all the indoor spaces and cleaning the ambiance. Ventilating of the buildings can also be helpful though it can not eliminate the exposures to smoke.
Nicotine is among the most harmful, addictive and available drugs globally ((Mokdad, AH, et al, 2004, pp. 1238). Though it is responsible for approximately 440, 000 deaths annually, tobacco related products and cigarettes products are locally available in the stores, liquor store and the supermarket (Mokdad, AH, et al, 2004, pp. 1238). Nicotine is as addictive as cocaine and heroine and over time a person becomes emotionally and physically dependent on, addictive to, nicotine.
Any lit cigarette can release more than 4,000 divergent chemicals of which 50 of them are carcinogens (Great Britain, parliament, House of commons & Health committee, 2005 pp. 8). Between the year 1964 and 2004, cigarette smoking caused approximately twelve million deaths, including 4.1 million cancer deaths , 5.5 million cardiovascular diseases deaths, 1.1 respiratory diseases deaths and 94,000 deaths of infants which was related to mothers smoking while pregnant (Buka & Niaura, 2003, pp. 1978-1984).
Cigarette smoking does account for approximately 1/3 of all the cancers including 90% of the lung cancer cases (National Cancer Institute, 2004). The smokeless tobacco for example chewing snuff and tobacco increases risks of cancer and most especially oral cancer. Use of tobacco causes lung diseases for example emphysema, stroke, vascular diseases, heart attack as well as aneurysm. In addition to that, it has also been linked to cases of cataracts as well as leukemia (National center for chronic disease prevention and health promotion, 2004). Basically, the adults who smoke usually die 14 years earlier as compared to the nonsmokers (National center for chronic disease prevention and health promotion, 2008).
Though nicotine is quite toxic and addictive, if it is ingested in very high doses, it usually des not cause cancer rather it is the chemicals that are responsible for severe effects of tobacco use. Tobacco smoke is usually a very complex mixture of various chemicals for example tar, cyanide, carbon monoxide, ammonia and formaldehyde. They increase the chances of various diseases. Most of the pregnant women who do smoke are at increased risks of miscarriage, premature infants, stillborn and infants with reduced birthweight. Maternal smoking can also be associated with behavioral and learning problems in children and they may end up being addicted.
Plan of action
Tobacco smoke causes both chronic and acute diseases and hence screening of the patients for tobacco use as well as offering them a smoking cessation can be a cost saving preventive strategy.
Research has shown that the smokers must deal with psychological as well as physical dependence in order to be fully successful at staying out and quitting. Exposures to tobacco smoke causes various symptoms for example post nasal drip, congestion, headache, shortness of breath, coughing, sneezing, runny nose, watery eyes among others. Also, people who live in smoky environments on daily basis are likely to experience some constant infections in their respiratory systems for example bronchitis and sinusitis.
There have been various laws that have been passed which are meant to restrict smoking in all the public places. For example the federal law has banned smoking on the domestic airline flights, trains as well as interstate buses. Smoking has also been banned in various federal owned buildings. For example, the Pro-Children Act of the year 1994 has prohibited smoking in the facilities which offer federally funded service to the children.
Tobacco addiction is usually a chronic disease which requires numerous attempts in order to quit. Though some of the smokers do quit without any help, others usually need assistance. Both medication and behavioral interventions can help the smokers a great deal to quit though combination of counseling and medication can be quite effective. Varenicline and Bupropion are the two FDA approved non nicotine medications which effectually increase the rates of long term abstinence. Bupropion is usually used in smoking cessation while varenicline withdraws the symptoms and also blocks the nicotine effects incase the people résumé to smoking.
Conclusion
Tobacco use causes both acute and chronic diseases. It is responsible for causing strokes, heart attacks, cancer, pulmonary diseases, emphysema and others. It causes millions of deaths annually and has a great negative economical and social impact. Exposures to the environmental tobacco use and smoke are a major preventable cause of a significant mortality and morbidity. Prevention of tobacco use in adults and children as well as reducing the nonsmokers’ exposures to tobacco smoke are important public health aims for the society. Communities therefore need to come up with a comprehensive strategy of reducing exposures to tobacco smoke, reduce the use of tobacco and increase on cessation of tobacco use. Improvements in all these categories will reduce tobacco related diseases, mortality and morbidity. The government should come up with firm laws and ban the use of tobacco as this will help the smokers to quit. Choosing of rational interventions which have shown to work in the past and matching it with the needs of the people are logical steps of establishing a comprehensive program. There should also be community education on health, social and economic effects of tobacco use as these will motivate people to modify on their smoking habits in order to reduce exposures to all the nonsmokers. The agencies should also increase the price of all tobacco products through legislation at the national level in order to raise these products’ taxes. In addition to that, there should be also mass media campaigns to inform the children as well as the adolescents to remain completely tobacco free. The healthcare providers should also offer counseling to tobacco patients and provide clinical therapies for example nicotine replacement.
