Data suggest that exposure to secondhand smoke can result in heart disease in nonsmoking adults. Recently, progress has been made in reducing involuntary exposure to secondhand smoke through legislation banning smoking in workplaces, restaurants, and other public places. The effect of legislation to ban smoking and its effects on the cardiovascular health of nonsmoking adults, however, remains a question.

Secondhand Smoke Exposure and Cardiovascular Effects reviews available scientific literature to assess the relationship between secondhand smoke exposure and acute coronary events. The authors, experts in secondhand smoke exposure and toxicology, clinical cardiology, epidemiology, and statistics, find that there is about a 25 to 30 percent increase in the risk of coronary heart disease from exposure to secondhand smoke. Their findings agree with the 2006 Surgeon General's Report conclusion that there are increased risks of coronary heart disease morbidity and mortality among men and women exposed to secondhand smoke. However, the authors note that the evidence for determining the magnitude of the relationship between chronic secondhand smoke exposure and coronary heart disease is not very strong.

Public health professionals will rely upon Secondhand Smoke Exposure and Cardiovascular Effects for its survey of critical epidemiological studies on the effects of smoking bans and evidence of links between secondhand smoke exposure and cardiovascular events, as well as its findings and recommendations.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON SECONDHAND SMOKE EXPOSURE AND ACUTE CORONARY EVENTS
• Reviewers
• Preface
• Summary
• 1. Introduction
  • CHARGE TO THE COMMITTEE
  • COMMITTEE’S APPROACH TO ITS CHARGE
  • SOURCES OF UNCERTAINTY IN KEY STUDIES
  • ORGANIZATION OF THIS REPORT
  • REFERENCES
• 2. Evaluating Exposure to Secondhand Smoke
  • CONSTITUENTS OF SECONDHAND SMOKE
  • MEASUREMENT OF SECONDHAND SMOKE
  • EXPOSURES TO SECONDHAND SMOKE
  • CONCLUSIONS
  • REFERENCES
• 3. Experimental Studies Relevant to the Pathophysiology of Secondhand Smoke
  • EFFECTS OF CIGARETTE SMOKE
  • EFFECTS OF CONSTITUENTS OF CIGARETTE SMOKE
  • SUMMARY OF POTENTIAL MODES OF ACTION OF ACUTE CORONARY EVENTS DUE TO SECONDHAND-TOBACCO SMOKE
  • CONCLUSIONS
  • REFERENCES
• 4. Epidemiologic Studies of Secondhand-Smoke Exposure and Cardiovascular Disease
  • RISK FACTORS FOR ACUTE CORONARY EVENTS
  • EPIDEMIOLOGY OF CHRONIC EXPOSURE TO SECONDHAND-TOBACCO SMOKE IN RELATION TO CORONARY HEART DISEASE AND ACUTE CORONARY EVENTS
  • CONCLUSIONS
  • REFERENCES
• 5. The Background of Smoking Bans
  • HISTORY OF U.S. SMOKING POLICIES
  • GLOBAL TOBACCO POLICIES
  • ISSUES SURROUNDING SMOKING BANS
  • CONCLUSIONS
  • REFERENCES
• 6. Overview of Key Studies of the Effects of Smoking Bans on Acute Coronary Events
  • HELENA, MONTANA
  • ITALY
  • PUEBLO, COLORADO
  • MONROE COUNTY, INDIANA
  • BOWLING GREEN, OHIO
  • NEW YORK STATE
  • SASKATCHEWAN, CANADA
  • SCOTLAND
  • REFERENCES
• 7. Synthesis of Key Studies Examining the Effect of Smoking Bans on Acute Coronary Events
  • LIMITATIONS AND SOURCES OF UNCERTAINTY IN KEY STUDIES
  • WEIGHT OF EVIDENCE FROM KEY STUDIES
  • CONCLUSIONS
  • REFERENCES
• 8. Conclusions and Recommendations
  • SUMMARY OF REPORT
  • SUMMARY OF OVERALL WEIGHT OF EVIDENCE
  • DATA GAPS AND RESEARCH RECOMMENDATIONS
  • COMMITTEE RESPONSES TO SPECIFIC QUESTIONS
  • REFERENCES
• Appendix Agendas of Public Meetings

This study was supported by Contract No. 200-2005-13434, TO#11 between the National Academy of Sciences and the U.S. Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2010. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.