Environmental Tobacco Smoke

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We support public health authorities' efforts to inform the public about the risks of smoking, and we believe that people should take their conclusions into account when deciding whether or not to smoke (See "Our positions"). We also understand that many people have concerns about exposure to environmental tobacco smoke (ETS), sometimes referred to as "involuntary" or "passive" smoking.

ETS, also known as "secondhand smoke," is a mixture of the exhaled smoke from smokers nearby and the smoke that drifts from the smoldering end of a cigarette between puffs. Compared to the smoke that a smoker inhales, ETS is aged and highly diluted.

We agree that ETS can be annoying to non-smokers and that in poorly ventilated areas ETS can cause substantial irritation of the eyes, nose and throat. We therefore ask all smokers to be aware of and show consideration for people with whom they come into contact. However, we do not believe that the claim that ETS is a cause of lung cancer, heart disease and chronic pulmonary diseases in non-smokers has been convincingly demonstrated or that a reliable causal link between ETS exposure and chronic diseases has been established.

The scientific literature on ETS and disease is inconsistent. For example, while the International Agency for Research on Cancer (IARC) concluded in a 2002 review "that involuntary smoking is a cause of lung cancer in never-smokers," the data from a large, multi-center study conducted in Europe and published by the same agency in 1998 did not show a statistically significant relationship between ETS exposure and lung cancer. More recently, a report on 35,000 California non-smoking adults published in 2003 in the British Medical Journal did not find a statistically significant increased risk for coronary heart disease and lung cancer arising from ETS exposure.

(See also reference to the 1993 U.S. Environmental Protection Agency Report on ETS.)

However, we do acknowledge that there are epidemiological studies that associate ETS exposure with childhood respiratory conditions such as the exacerbation of asthma and the increased occurrence of respiratory tract infections. We also acknowledge that a number of epidemiological studies have associated ETS exposure with Sudden Infant Death Syndrome.

We recognize that infants, young children, and adults with respiratory problems can be especially vulnerable to exposure to environmental substances, whatever the sources. Furthermore, infants and young children cannot take remedial action such as requesting that smoking be stopped, asking for additional ventilation or leaving the area. We therefore recommend that people do not smoke when they are present.