TOBACCO SMOKE (ETS-Environmental Tobacco Smoke)

Tobacco smoke represents the single largest environmental cause of illness and death in western civilization. Despite adequate information individuals continue to smoke and expose others around them to this smoke. Everyone is aware that smoking causes lung cancer and a host of other cancers, heart disease, emphysema (COPD), small birth weight babies, and contributes to multiple other diseases. Unfortunately, any individual exposed to second hand tobacco smoke (ETS) also experiences an increase in risk for all these diseases. It is estimated that a non-smoker living in the same house as a smoker, inhales approximately 30% of the tobacco smoke that the actual smoker does. I have seen many non-smokers die of cancer or heart disease because their spouse smoked for years. Exposure to ETS roughly doubles the risk of a child developing asthma. This risk starts when the baby is being carried inside mothers' womb (if mom smokes) and continues if either parent smokes inside the family house or in the family vehicle. Although these risks are well known, individuals continue to smoke, and what really upsets me, is that they continue to expose others to this deadly environmental toxin. I am continually surprised by the fact that smokers actually rarely understand what they are breathing in.

Composition of ETS

Over 4000 different chemicals have been clearly identified in tobacco smoke. A large number of these chemicals are extremely powerful chemical irritants and carcinogens. Individuals with allergy or asthma will always be adversely affected by ETS because the lining of their respiratory system (from nose to chest) are already inflammed due to the allergic inflammatory process (please go to Contents and read the Basics in Respiratory Allergy, if you have not done so) and exposure to powerful chemical irritation always increases respiratory symptoms. Some individuals are actually allergic to the tobacco component. Approximately 40 percent of a cigarette is not tobacco, but is made up of the fillers, chemicals in tobacco (i.e. pesticides, fertilizers, additives), the paper wrapping, and the filter. So what exactly do you breathe in when exposed to ETS :

-Carbon dioxide-a gas produced when burning any carbon based compound and causing the "greenhouse effect"

-Carbon monoxide-a odourless, invisible gas that is exceedingly toxic and in large amounts rapidly fatal. It is highly toxic to the blood in humans because of its high affinity for a component in red blood cells (over 200 times the affinity of ordinary oxygen). The low tar cigarettes often induce an increase in the depth of inhalation to maintain nicotine levels and this compensation actually increases the amount of carbon monoxide that low tar cigarette smokers absorb.

-Tar-the particulate matter (the solid particles) in ETS contains a huge number of chemicals and organic compounds. Many of these are directly carcinogenic including the family of polycyclic hydrocarbons and nitrosamines.

-Nicotine-the best know component, which causes physiological addiction. Interestingly, nicotine in any other form other than tobacco products is strictly controlled as a poison by government regulations. It used to be used as a pesticide in the early 1900's but was abandoned because it was too toxic. All other forms of nicotine (such as the gum and patch) are strictly regulated under the government pharmaceutical regulations.

-Nitrogen oxides-occur in high concentration in tobacco smoke and are regarded as one of the primary pollutants in our atmosphere.

- Hydrogen cyanide, benzene, ammonia, and formaldehyde are found routinely in tobacco smoke and all directly damage the function of the respiratory lining.

-Heavy metals- are deadly to humans and all exposures are cumulative throughout an individuals lifetime. Lead is the best known, but nickel, arsenic, cadmium, and chromium, are all routinely found and up to 30 heavy metals have been identified.

-Radioactive compounds-which are all carcinogenic have been identified in ETS including polonium-210, potassium-40, radium-226, radium-228, and thorium-228.

This list is not all-inclusive. I will leave you with this final thought. When a cigarette burns you are burning multiple chemicals to create other toxins. The paper wrapping is a chlorinated product and burning chlorine-containing material produces some of the most deadly and environmentally permanent toxins that we are aware of (i.e. dioxins, etc.). Bruce Sweet M.D. 2001