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Passive Smoking and Cardiovascular Risk

Passive Smoking and Cardiovascular Risk Abstract A possible relationship between passive smoking and coronary heart disease has been widely debated during the past decade. Convincing evidence links environmental (passive) tobacco smoke exposure to heart disease morbidity as well as mortality. In the United States, 37 000 coronary heart disease deaths per year are attributed to environmental tobacco smoke exposure, accounting for 70% of all deaths caused by environmental tobacco smoke. The analysis of 10 epidemiologic studies indicated a consistent dose-response effect related to exposure, but more proof is still needed. Evidence indicates that nonsmokers are more sensitive to smoke, including cardiovascular effects, and that sidestream smoke contains higher concentrations of gas constituents, including carbon monoxide. Pathophysiological and biochemical data after short- and long-term environmental tobacco smoke exposure show changes in endothelial and platelet function as well as exercise capacity similar to those in active smoking. Therefore, passive smoking is a relevant risk factor for heart disease morbidity and mortality. (Arch Intern Med. 1995;155:1942-1948) References 1. Hoffman D, Haley NJ, Brunneman KD. Cigarette sidestream smoke: formation, analysis and model studies on the uptake by nonsmokers. Presented at the U.S.-Japan Meeting on New Etiology of Lung Cancer; March 22,1983; Honolulu, Hawaii. 2. US Department of Health and Human Services. The Health Consequences of Smoking: Cancer: A Report of the Surgeon General . Washington, DC: US Dept of Health and Human Services; 1982. 3. Klus H, Kuhn H. Distribution of various tobacco smoke components among mainstream smoke and sidestream smoke: a survey. Beitr Tabakforsch Int . 1982;11:229-232. 4. Committee on Passive Smoking of the National Research Council. The Physiochemical Nature of Sidestream Smoke and Environmental Tobacco Smoke: Measuring Exposure and Assessing Health Effects . Washington, DC: National Academy Press; 1986. 5. Feyerabend C, Higenbottam T, Russell MAH. Nicotine concentrations in urine and saliva of smokers and nonsmokers. BMJ . 1982;284:1002-1004.Crossref 6. Maclure M, Katz RB, Bryant MS, Skipper PL, Tannenbaum SR. Elevated blood levels of carcinogens in passive smokers. Am J Public Health . 1989;79:1381-1384.Crossref 7. Matsukura S, Taminato T, Kitano N, et al. Effects of environmental tobacco smoke on urinary cotinine excretion in nonsmokers: evidence for passive smoking. N Engl J Med . 1984;311:828-832.Crossref 8. Coultas DB, Peake GT, Samet JM. Questionnaire assessment of lifetime and recent exposure to environmental tobacco smoke. Am J Epidemiol . 1989;130:338. 9. Cummings KM, Markello SJ, Mahoney MC, Marshall JR. Measurement of lifetime exposure to passive smoke. Am J Epidemiol . 1989;130:122-132. 10. Gvozdjáková A, Bada V, Sány L, et al. Smoke cardiomyopathy: disturbance of oxidative processes in myocardial mitochondria. Cardiovasc Res . 1984;18:229-232.Crossref 11. Gvozdjáková A, Kucharská J, Sány L, Bada V, Bozek P, Gvozdják J. Effect of smoking on the cytochrome and oxidase system of the myocardium. Bratisl Lek Listy . 1985;83:10-15. 12. Gvozdják J, Gvozdjáková A, Kucharská J, Bada V. The effect of smoking on myocardial metabolism. Czech Med . 1987;10:47-53. 13. Gvozdjáková A, Kucharská J, Gvozdják J. The effect of passive smoking and alcohol on cardiomyocytes in rabbits. Vnitr Lek . 1989;35:363-369. 14. Gvozdjáková A, Kucharská J, Gvozdják J. Effect of smoking on the oxidative processes of cardiomyocytes. Cardiology . 1992;81:81-84.Crossref 15. Kjeldsen K, Thomsen H, Astrup P. Effects of carbon monoxide on myocardium: ultrastructural changes in rabbits after moderate, chronic exposure. Circ Res . 1974;34:339-348.Crossref 16. Thomsen H, Kjeldsen K. Threshold limit for carbon monoxide-induced myocardial damage. Arch Environ Health . 1974;29:73-78.Crossref 17. Lough J. Cardiomyopathy produced by cigarette smoke. Arch Pathol Lab Med . 1978;102: 377-380. 18. Du BY. The effects of passive smoking on health. Chung Hua Chieh Ho Ho Hu Hsi Tsa Chih . 1991; 14:76-78. 19. Aranow WS. Effect of passive smoking on angina pectoris. N Engl J Med . 1978;299:21-23.Crossref 20. Khalfen ES, Klochkov VA. Effect of passive smoking on physical tolerance of ischemic coronary heart disease patients. Ter Arkh . 1987;59:112-115. 21. McMurray RG, Hicks LL, Thompson DL. The effects of passive inhalation of cigarette smoke on exercise performance. Eur J Appl Physiol . 1985; 54:196-200.Crossref 22. Lee PN, Chamberlain J, Alderson M. Relationship of passive smoking to risk of lung cancer and other smoking-associated diseases. Br J Cancer . 1986;54:97-105.Crossref 23. Svendsen KH, Kuller LH, Martin MJ, Ockene JK. Effects of passive smoking in the Multiple Risk Factor Intervention Trial. Am J Epidemiol . 1987; 126:783-795. 24. Hole DJ, Gillis CR, Chopra C, Hawthorne VM. Passive smoking and cardiorespiratory health in a general population in the west of Scotland. BMJ . 1989;299:423-427.Crossref 25. Garland C, Barrett-Connor E, Suarez L, Criqui MH, Wingard DL. Effects of passive smoking on ischemic coronary heart disease mortality of nonsmokers: a prospective study. Am J Epidemiol . 1985;121:645-650.Crossref 26. Hirayama T. Passive smoking: a new target of epidemiology. Tokai J Exp Clin Med . 1985;10: 287-293. 27. Helsing KJ, Sandler DP, Comstock GW, Chee E. Heart disease mortality in nonsmokers living with smokers. Am J Epidemiol . 1988;127:915-922. 28. He Y. Women's passive smoking and coronary heart disease. Chung Hua Yu Fang I Hsueh Tsa Chih . 1989;23:19-22. 29. Humble C, Croft J, Gerber A, Casper M, Hames CG, Tyroler HA. Passive smoking and 20-year cardiovascular disease mortality among nonsmoking wives, Evans County, Georgia. Am J Public Health . 1990;80:599-601.Crossref 30. Dobson AJ, Alexander HM, Heller RF, Lloyd DM. Passive smoking and the risk of heart attack or coronary death. Med J Aust . 1991;154:793-797. 31. Kawachi I, Pearce NE, Jackson RT. Deaths from lung cancer and ischaemic coronary heart disease due to passive smoking in New Zealand. N Z Med J . 1989;102:337-340, 448. 32. Moskowitz WB, Mosteller M, Schieken RM, et al. Lipoprotein and oxygen transport alterations in passive smoking preadolescent children: the MCV Twin Study. Circulation . 1990;81:586-592.Crossref 33. Sandler DP, Comstock GW, Helsing KJ. Shore DL. Deaths from all causes in nonsmokers who lived with smokers. Am J Public Health . 1989; 79:163-167.Crossref 34. Feldman J, Shenker IR, Etzel RA, et al. Passive smoking alters lipid profiles in adolescents. Pediatrics . 1991;88:259-264. 35. Fuster V, Cheseboro JH, Frye RL, Elveback LR. Platelet survival and the development of coronary artery disease in the young adult: effects of cigarette smoking, strong family history and medical therapy. Circulation . 1981;63:546-551.Crossref 36. Ross R, Glomset JA. The pathogenesis of atherosclerosis. N Engl J Med . 1976;295:369-374.Crossref 37. Davis JW, Shelton L, Eigenberg DA, Hignite C, Watanabe IS. Effects of tobacco and non-tobacco cigarette smoking on endothelium and platelets. Clin Pharmacol Ther . 1985;37:529-533.Crossref 38. Davis JW, Hartmann CR, Lewis HD Jr, et al. Cigarette smoking-induced enhancement of platelet function: lack of prevention by aspirin in men with coronary artery disease. J Lab Clin Med . 1985;105:479-483. 39. Davis JW, Shelton L, Eigenberg DA. Lack of effect of aspirin on cigarette smoke-induced increase in circulating endothelial cells. Haemostasis . 1987;17:66-69. 40. Davis JW, Shelton L, Hartman CR, Eigenberg DA, Ruttinger HA. Smoking-induced changes in endothelium and platelets are not affected by hydroxyethylrutosides. Br J Exp Pathol . 1986;67: 765-771. 41. Davis JW, Shelton L, Watanabe IS, Arnold J. Passive smoking affects endothelium and platelets. Arch Intern Med . 1989;149:386-389.Crossref 42. Sinzinger H, Kefalides A. Passive smoking severely decreases platelet sensitivity to antiaggregatory prostaglandins. Lancet . 1982;2:392-393.Crossref 43. Burghuber OC, Punzengruber C, Sinzinger H, Haber P, Silberbauer K. Platelet sensitivity to prostacyclin in smokers and non-smokers. Chest . 1985; 90:34-38.Crossref 44. Kritz H, Schmid P, Karanikas G, et al. Passive smoking increases platelet thromboxane. Int J Angiol . In press. 45. Bounameaux H, Griessen M, Benedet P, Krahenbuhl B, Deom A. Nicotine induced haemodynamic changes during cigarette smoking and nicotine gum chewing: a placebo controlled study in young healthy volunteers. Cardiovasc Res . 1988;22:154-158.Crossref 46. Albert RE, Vanderlaan M, Burns FJ, Mishitumi M. Effects of carcinogens on chicken atherosclerosis. Cancer Res . 1977;37:2232-2235. 47. Penn A, Batastini G, Soloman J, Burns F, Albert R. Dose-dependent size increases of aortic lesions following chronic exposure to 7,12-dimethylbenz(a)anthracene. Cancer Res . 1981; 41:588-592. 48. Allred EN, Bleecker ER, Chaitman BR, et al. Short-term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease. N Engl J Med . 1989;321: 1426-1432.Crossref 49. Sheps DS, Herbst MC, Hinderliter AL, et al. Production of arrhythmias by elevated carboxyhemoglobin in patients with coronary artery disease. Ann Intern Med . 1990;113:343-351.Crossref 50. Anderson R, Theron AJ, Richards GA, Myer MS, van Rensburg AJ. Passive smoking by humans sensitizes circulating neutrophils. Am Rev Respir Dis . 1991;144:570-574.Crossref 51. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General of the Public Health Service . Washington, DC: US Dept of Health and Human Services, Public Health Service; 1986. 52. Schouten EG, Dekker JM, Kok FJ, et al. Risk ratio and rate ratio estimation in case-cohort designs: hypertension and cardiovascular mortality. Stat Med . 1993;12:1733-1745.Crossref 53. Wells A. An estimate of adult mortality in the United States from passive smoking: a response to criticism. Environ Int . 1990;16:187-193.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Passive Smoking and Cardiovascular Risk

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American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1995.00430180034005
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Abstract

Abstract A possible relationship between passive smoking and coronary heart disease has been widely debated during the past decade. Convincing evidence links environmental (passive) tobacco smoke exposure to heart disease morbidity as well as mortality. In the United States, 37 000 coronary heart disease deaths per year are attributed to environmental tobacco smoke exposure, accounting for 70% of all deaths caused by environmental tobacco smoke. The analysis of 10 epidemiologic studies indicated a consistent dose-response effect related to exposure, but more proof is still needed. Evidence indicates that nonsmokers are more sensitive to smoke, including cardiovascular effects, and that sidestream smoke contains higher concentrations of gas constituents, including carbon monoxide. Pathophysiological and biochemical data after short- and long-term environmental tobacco smoke exposure show changes in endothelial and platelet function as well as exercise capacity similar to those in active smoking. Therefore, passive smoking is a relevant risk factor for heart disease morbidity and mortality. (Arch Intern Med. 1995;155:1942-1948) References 1. Hoffman D, Haley NJ, Brunneman KD. Cigarette sidestream smoke: formation, analysis and model studies on the uptake by nonsmokers. Presented at the U.S.-Japan Meeting on New Etiology of Lung Cancer; March 22,1983; Honolulu, Hawaii. 2. US Department of Health and Human Services. The Health Consequences of Smoking: Cancer: A Report of the Surgeon General . Washington, DC: US Dept of Health and Human Services; 1982. 3. Klus H, Kuhn H. Distribution of various tobacco smoke components among mainstream smoke and sidestream smoke: a survey. Beitr Tabakforsch Int . 1982;11:229-232. 4. Committee on Passive Smoking of the National Research Council. The Physiochemical Nature of Sidestream Smoke and Environmental Tobacco Smoke: Measuring Exposure and Assessing Health Effects . Washington, DC: National Academy Press; 1986. 5. Feyerabend C, Higenbottam T, Russell MAH. Nicotine concentrations in urine and saliva of smokers and nonsmokers. BMJ . 1982;284:1002-1004.Crossref 6. Maclure M, Katz RB, Bryant MS, Skipper PL, Tannenbaum SR. Elevated blood levels of carcinogens in passive smokers. Am J Public Health . 1989;79:1381-1384.Crossref 7. Matsukura S, Taminato T, Kitano N, et al. Effects of environmental tobacco smoke on urinary cotinine excretion in nonsmokers: evidence for passive smoking. N Engl J Med . 1984;311:828-832.Crossref 8. Coultas DB, Peake GT, Samet JM. Questionnaire assessment of lifetime and recent exposure to environmental tobacco smoke. Am J Epidemiol . 1989;130:338. 9. Cummings KM, Markello SJ, Mahoney MC, Marshall JR. Measurement of lifetime exposure to passive smoke. Am J Epidemiol . 1989;130:122-132. 10. Gvozdjáková A, Bada V, Sány L, et al. Smoke cardiomyopathy: disturbance of oxidative processes in myocardial mitochondria. Cardiovasc Res . 1984;18:229-232.Crossref 11. Gvozdjáková A, Kucharská J, Sány L, Bada V, Bozek P, Gvozdják J. Effect of smoking on the cytochrome and oxidase system of the myocardium. Bratisl Lek Listy . 1985;83:10-15. 12. Gvozdják J, Gvozdjáková A, Kucharská J, Bada V. The effect of smoking on myocardial metabolism. Czech Med . 1987;10:47-53. 13. Gvozdjáková A, Kucharská J, Gvozdják J. The effect of passive smoking and alcohol on cardiomyocytes in rabbits. Vnitr Lek . 1989;35:363-369. 14. Gvozdjáková A, Kucharská J, Gvozdják J. Effect of smoking on the oxidative processes of cardiomyocytes. Cardiology . 1992;81:81-84.Crossref 15. Kjeldsen K, Thomsen H, Astrup P. Effects of carbon monoxide on myocardium: ultrastructural changes in rabbits after moderate, chronic exposure. Circ Res . 1974;34:339-348.Crossref 16. Thomsen H, Kjeldsen K. Threshold limit for carbon monoxide-induced myocardial damage. Arch Environ Health . 1974;29:73-78.Crossref 17. Lough J. Cardiomyopathy produced by cigarette smoke. Arch Pathol Lab Med . 1978;102: 377-380. 18. Du BY. The effects of passive smoking on health. Chung Hua Chieh Ho Ho Hu Hsi Tsa Chih . 1991; 14:76-78. 19. Aranow WS. Effect of passive smoking on angina pectoris. N Engl J Med . 1978;299:21-23.Crossref 20. Khalfen ES, Klochkov VA. Effect of passive smoking on physical tolerance of ischemic coronary heart disease patients. Ter Arkh . 1987;59:112-115. 21. McMurray RG, Hicks LL, Thompson DL. The effects of passive inhalation of cigarette smoke on exercise performance. Eur J Appl Physiol . 1985; 54:196-200.Crossref 22. Lee PN, Chamberlain J, Alderson M. Relationship of passive smoking to risk of lung cancer and other smoking-associated diseases. Br J Cancer . 1986;54:97-105.Crossref 23. Svendsen KH, Kuller LH, Martin MJ, Ockene JK. Effects of passive smoking in the Multiple Risk Factor Intervention Trial. Am J Epidemiol . 1987; 126:783-795. 24. Hole DJ, Gillis CR, Chopra C, Hawthorne VM. Passive smoking and cardiorespiratory health in a general population in the west of Scotland. BMJ . 1989;299:423-427.Crossref 25. Garland C, Barrett-Connor E, Suarez L, Criqui MH, Wingard DL. Effects of passive smoking on ischemic coronary heart disease mortality of nonsmokers: a prospective study. Am J Epidemiol . 1985;121:645-650.Crossref 26. Hirayama T. Passive smoking: a new target of epidemiology. Tokai J Exp Clin Med . 1985;10: 287-293. 27. Helsing KJ, Sandler DP, Comstock GW, Chee E. Heart disease mortality in nonsmokers living with smokers. Am J Epidemiol . 1988;127:915-922. 28. He Y. Women's passive smoking and coronary heart disease. Chung Hua Yu Fang I Hsueh Tsa Chih . 1989;23:19-22. 29. Humble C, Croft J, Gerber A, Casper M, Hames CG, Tyroler HA. Passive smoking and 20-year cardiovascular disease mortality among nonsmoking wives, Evans County, Georgia. Am J Public Health . 1990;80:599-601.Crossref 30. Dobson AJ, Alexander HM, Heller RF, Lloyd DM. Passive smoking and the risk of heart attack or coronary death. Med J Aust . 1991;154:793-797. 31. Kawachi I, Pearce NE, Jackson RT. Deaths from lung cancer and ischaemic coronary heart disease due to passive smoking in New Zealand. N Z Med J . 1989;102:337-340, 448. 32. Moskowitz WB, Mosteller M, Schieken RM, et al. Lipoprotein and oxygen transport alterations in passive smoking preadolescent children: the MCV Twin Study. Circulation . 1990;81:586-592.Crossref 33. Sandler DP, Comstock GW, Helsing KJ. Shore DL. Deaths from all causes in nonsmokers who lived with smokers. Am J Public Health . 1989; 79:163-167.Crossref 34. Feldman J, Shenker IR, Etzel RA, et al. Passive smoking alters lipid profiles in adolescents. Pediatrics . 1991;88:259-264. 35. Fuster V, Cheseboro JH, Frye RL, Elveback LR. Platelet survival and the development of coronary artery disease in the young adult: effects of cigarette smoking, strong family history and medical therapy. Circulation . 1981;63:546-551.Crossref 36. Ross R, Glomset JA. The pathogenesis of atherosclerosis. N Engl J Med . 1976;295:369-374.Crossref 37. Davis JW, Shelton L, Eigenberg DA, Hignite C, Watanabe IS. Effects of tobacco and non-tobacco cigarette smoking on endothelium and platelets. Clin Pharmacol Ther . 1985;37:529-533.Crossref 38. Davis JW, Hartmann CR, Lewis HD Jr, et al. Cigarette smoking-induced enhancement of platelet function: lack of prevention by aspirin in men with coronary artery disease. J Lab Clin Med . 1985;105:479-483. 39. Davis JW, Shelton L, Eigenberg DA. Lack of effect of aspirin on cigarette smoke-induced increase in circulating endothelial cells. Haemostasis . 1987;17:66-69. 40. Davis JW, Shelton L, Hartman CR, Eigenberg DA, Ruttinger HA. Smoking-induced changes in endothelium and platelets are not affected by hydroxyethylrutosides. Br J Exp Pathol . 1986;67: 765-771. 41. Davis JW, Shelton L, Watanabe IS, Arnold J. Passive smoking affects endothelium and platelets. Arch Intern Med . 1989;149:386-389.Crossref 42. Sinzinger H, Kefalides A. Passive smoking severely decreases platelet sensitivity to antiaggregatory prostaglandins. Lancet . 1982;2:392-393.Crossref 43. Burghuber OC, Punzengruber C, Sinzinger H, Haber P, Silberbauer K. Platelet sensitivity to prostacyclin in smokers and non-smokers. Chest . 1985; 90:34-38.Crossref 44. Kritz H, Schmid P, Karanikas G, et al. Passive smoking increases platelet thromboxane. Int J Angiol . In press. 45. Bounameaux H, Griessen M, Benedet P, Krahenbuhl B, Deom A. Nicotine induced haemodynamic changes during cigarette smoking and nicotine gum chewing: a placebo controlled study in young healthy volunteers. Cardiovasc Res . 1988;22:154-158.Crossref 46. Albert RE, Vanderlaan M, Burns FJ, Mishitumi M. Effects of carcinogens on chicken atherosclerosis. Cancer Res . 1977;37:2232-2235. 47. Penn A, Batastini G, Soloman J, Burns F, Albert R. Dose-dependent size increases of aortic lesions following chronic exposure to 7,12-dimethylbenz(a)anthracene. Cancer Res . 1981; 41:588-592. 48. Allred EN, Bleecker ER, Chaitman BR, et al. Short-term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease. N Engl J Med . 1989;321: 1426-1432.Crossref 49. Sheps DS, Herbst MC, Hinderliter AL, et al. Production of arrhythmias by elevated carboxyhemoglobin in patients with coronary artery disease. Ann Intern Med . 1990;113:343-351.Crossref 50. Anderson R, Theron AJ, Richards GA, Myer MS, van Rensburg AJ. Passive smoking by humans sensitizes circulating neutrophils. Am Rev Respir Dis . 1991;144:570-574.Crossref 51. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General of the Public Health Service . Washington, DC: US Dept of Health and Human Services, Public Health Service; 1986. 52. Schouten EG, Dekker JM, Kok FJ, et al. Risk ratio and rate ratio estimation in case-cohort designs: hypertension and cardiovascular mortality. Stat Med . 1993;12:1733-1745.Crossref 53. Wells A. An estimate of adult mortality in the United States from passive smoking: a response to criticism. Environ Int . 1990;16:187-193.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 9, 1995

References