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Dangers of Smoking Label

The FDA’s 9 New Cigarette Health Warnings

September 22, 2012 marks a monumental change in the appearance of cigarette packaging in the United States.

At this time, new warning labels must appear on all cigarette packs. Each warning targets a specific danger of smoking with a graphic color image that communicates the intent of the warning. There were 9 significant warnings decided upon out of the initial 36 proposed in November 2010 when the label revamping ruling selection began. Part of the process included a time of evaluating public comments.

On September 22, 2012 big tobacco manufacturers will no longer be able to distribute cigarettes in the United States unless their package designs display the one of the 9 warning labels.

Graphic Incentives to Quit Smoking

New FDA Cigarette Package Warning LabelThe final selection of 9 FDA cigarette warning labels hope to target youth smokers making them more aware to empower them to never start smoking. The labels also increase awareness of the some of the health risks and diseases related to smoking by providing a graphic incentive to appeal to smokers to get them to quit.

Since research suggests that nicotine is as addictive as heroin, cocaine, or alcohol and that the frequency of smoking is often what prevents people from quitting, a strong intent behind these graphic labels is that perhaps each time someone picks up a pack, the image could put them over the edge into the say no or quit category.

The 9 cigarette label warnings cover these concerns:

  1. Cigarettes are addictive.
  2. Tobacco smoke can harm your children.
  3. Cigarettes cause fatal lung disease.
  4. Cigarettes cause cancer.
  5. Cigarettes cause strokes and heart disease.
  6. Smoking during pregnancy can harm your baby.
  7. Smoking can kill you.
  8. Tobacco smoke causes fatal lung disease in nonsmokers.
  9. Quitting smoking now greatly reduces serious risks to your health.

Along with each of the warnings are corresponding smoking facts that give smokers a lot to think about.

Not Soon Enough for Many

We can’t help but think how many lives would have been different had smokers truly been informed of the dangers of inhaling tobacco smoke before they picked up their habit or exposed others to the toxic fumes. I think only those with a death wish would have started smoking or exposed their loved ones.

Just recently, we received this heartbreaking letter from a caregiver taking care of a parent who developed serious health problems brought on from smoking and died a horrible death. Should we all have the choice of a better quality of life?

Smoking Killed my Mom: 4 Years As A Caregiver

FDA Warning LabelThere are no words to express fully express our condolences to the author of this letter. For their privacy we are not including their name, but the content is published in its unedited form:

Thank you so much for taking the time to express your condolences. I am devastated by the loss of my mother, and I am not handling her death well at all. The fact that it was so senseless makes it that much harder to bear. The fact that she suffered so needlessly…

She had gangrene in her little toe. That’s how it all started. She needed surgery to unblock her right carotid artery. It was discovered that her circulation was completely blocked from her right hip to her foot. The surgeons unblocked the arteries and put stents in. Her toe even healed, but she wouldn’t quit smoking. When she started showing signs of the same problem, I made her quit. We got into huge arguments, but it was already too late. They ended up amputating the entire front of her right foot.

Every day, I had to change her bandage at least twice. I had to flush this gaping, horrific wound, put antibiotic cream over it, then re-wrap it in clean gauze. Every night, I had to listen to her beg me for more pain medication that I could not give her. After three months of hell, the doctors amputated her right leg below the knee. This wound healed, but her independence had been seriously compromised forever. Her ability to breathe was rapidly deteriorating as well.

StethoscopeNear the end of March 2010, she said she needed to go to the hospital because she couldn’t breathe. Five minutes more, and they would have had to intubate her. They put her on steroids to help reduce the inflammation in her seriously damaged lungs. A few days later, they did a bronchoscopy and suctioned a bunch of crap out of her lungs. She was sent to a nursing home to recoup. The steroids raised her blood sugar and made insulin necessary. They also caused her to gain a significant amount of weight, which further hindered her ability to breathe.

Right before she was due to come home, the nursing home sent her to the ER. When my best friend and I arrived, she wasn’t in any distress. Mom really wasn’t sure why they had sent her at all. Unfortunately, sitting on the gurney for so long caused a massive cramp in her hip. She went into respiratory distress and deteriorated rapidly. She wound up staying in the hospital for a week. That’s when her doctor called and told me that there was no way I would be able to handle her care on my own anymore. He ordered her to be placed in a nursing home. You don’t even want to know the hell that the two of us went through with that place. She had pneumonia in December of 2010. When she had sufficiently recovered, they had to amputate her left leg below the knee as well.

The Saturday before she died (she died the week of Easter Sunday), I went to pick up her laundry as usual. She was sleeping, but very restless. She cried out in pain and sat straight up in bed. I asked her if she was okay. She said yes. I asked her why she hadn’t eaten any of her dinner yet (her tray was untouched, unusual for her). She picked up her fork and started pushing the food around. “I’ve been eating” she said. I went to fill her pitcher with fresh ice water. I came back and she was sound asleep again.

I asked the two aides in the room how long she had been like this. They shrugged and said, “She’s been making those funny noises all day.” I explained to them that only once in a while was normal and that they should be a ‘tad more concerned’ (I was being very sarcastic, of course). I went out into the hall to speak with the nurse, who informed me that Mom had been complaining of pain in her right hip, so they gave her (insert name of a narcotic pain pill here). I shook my head ‘no’, and told the nurse that the only pain reliever her doctor had ever approved was regular-strength Tylenol. Narcotic pain pills suppress the breathing too much in people with COPD. She said that’s what the doctor had ordered. Turns out it wasn’t her doctor, but the doctor on call.

Symbol for No SmokingTuesday morning at 6:30 a.m., the phone rings. Mom’s eyes were open, but she was non-responsive. By the time my brother and I reached the hospital she was already gone. To have to see her laying on that gurney just about killed me. I honest to god don’t think I’m going to get through this. I am beyond furious that these companies can literally get away with murder. Nobody you love should have to die the way my mother did. I did everything in my power to make her well. I failed. I don’t think I can live with that, especially since I’m about to lose our house and everything my family ever owned. I am terrified out of my wits. Sorry this is so long…I just needed to talk. There’s so much that I left out of this…so much more. Never have I known a hell like what we had to go through. It just isn’t right.

It is our hopes that you will pass on this article on to others who are enticed to smoke, or your loved ones who do. Sometimes a wake up call like this true story can make a huge difference.

Since 1878 Reports Confirmed Smoking Was a Health Hazard

1878: Eighty-six years before the U.S. surgeon general issues a report confirming the dangers of smoking tobacco, a letter from English physician Charles R. Drysdale condemning its use appears in The Times of London.

Drysdale, the senior physician to the Metropolitan Free Hospital in London, had already published a book on this subject titled Tobacco and the Diseases It Produces, when he wrote the letter that described smoking as “the most evident of all the retrograde influences of our time.”

Drysdale had been on an anti-smoking crusade since at least 1864, the year he published a study documenting the effects on young men of consuming ¾ ounce of tobacco daily. That study reported cases of jaundice, and at least one subject having “most distressing palpitations of the heart.”

Drysdale’s book pinpointed nicotine as the dangerous agent and reported its ill effects on the lungs, circulation system, even the skin.

Havana-cut tobacco contained roughly 2 percent nicotine, while Virginia tobacco was a more toxic 7 percent, Drysdale pointed out. (Tobacco was a product of the New World and had to be imported to Europe.)

He also warned against exposure to second-hand smoke: “Women who wait in public bar-rooms and smoking-saloons, though not themselves smoking, cannot avoid the poisoning caused by inhaling smoke continually. Surely gallantry, if not common honesty, should suggest the practical inference from this fact.”

The prolific Drysdale wrote on a variety of other related subjects as well, including medicine as a profession for women and issues related to population control.

Despite Drysdale’s warnings, and despite the establishment of numerous anti-smoking movements, little was done to curb smoking anywhere in the world.

Though physicians and scientists understood there were numerous health hazards associated with the practice, the number of smokers increased dramatically in the first half of the 20th century. Thank you, Madison Avenue. Thank you, Hollywood.

The turning point probably came in 1957, when then-Surgeon General Leroy Burney reported a causal link between smoking and lung cancer. It was left to Burney’s successor, Luther Terry, to lower the boom.

Under Terry’s direction, a special committee produced Smoking and Health: Report of the Advisory Committee to the Surgeon General.

This 1964 bombshell — so volatile that it was released on a Saturday to minimize the effect on the stock market — began a massive change in people’s attitudes toward smoking.

And to think it only took 86 years.

Big Tobacco Companies Covered Up Radiation Dangers From Smoking

Tobacco companies have covered up for 40 years the fact that cigarette smoke contains a dangerous radioactive substance that exposes heavy smokers to the radiation equivalent of having 300 chest X-rays a year.

Internal company records reveal that cigarette manufacturers knew that tobacco contained polonium-210 but avoided drawing public attention to the fact for fear of “waking a sleeping giant”.

Polonium-210 emits alpha radiation estimated to cause about 11,700 lung cancer deaths each year worldwide. Russian dissident and writer Alexander Litvinenko died after being poisoned with polonium-210 in 2006.

The polonium-210 in tobacco plants comes from high-phosphate fertilisers used on crops. The fertiliser is manufactured from rocks that contain radioisotopes such as polonium-210 (PO-210).
The radioactive substance is absorbed through the plant’s roots and deposited on its leaves. 

People who smoke one-and-a-half packets of cigarettes a day are exposed to as much radiation as they would receive from 300 chest X-rays a year, according to research.

New health warning labels such as “Cigarettes are a major source of radiation exposure” have been urged by the authors of a study published in this month’s American Journal of Public Health. 

“This wording would capitalise on public concern over radiation exposure and increase the impact of cigarette warning labels,” the Mayo Clinic and Stanford University authors say.

Quit Victoria executive director Fiona Sharkie said Australian tobacco companies were not legally obliged to reveal the levels of chemicals contained in cigarettes. This made it difficult to know exactly how damaging PO-210 was and meant it was impossible to know what effect it had on other poisons contained in cigarettes.

“It (PO-210) is obviously highly toxic and we applaud any efforts to publicise the dangers,” she said. “But the industry needs to be better regulated before we can support specific warnings.” 

Inhalation tests have shown that PO-210 is a cause of lung cancer in animals. It has also been estimated to be responsible for 1% of all US lung cancers, or 1600 deaths a year.

The US authors analysed 1500 internal tobacco company documents, finding that tobacco companies conducted scientific studies on removing polonium-210 from cigarettes but were unable to do so.  “Documents show that the major transnational cigarette manufacturers managed the potential public relations problem of PO-210 in cigarettes by avoiding any public attention to the issue.”

Second Hand Smoke Laces the AirPhilip Morris even decided not to publish internal research on polonium-210 which was more favourable to the tobacco industry than previous studies for fear of heightening public awareness of PO-210.

Urging his boss not to publish the results, one scientist wrote: “It has the potential of waking a sleeping giant.” Tobacco company lawyers played a key role in suppressing information about the research to protect the companies from litigation.

The journal authors, led by Monique Muggli, of the nicotine research program at the Mayo Clinic, say: “The internal debate, carried on for the better part of a decade, involved most cigarette manufacturers and pitted tobacco researchers against tobacco lawyers. The lawyers prevailed.

“Internal Philip Morris documents suggest that as long as the company could avoid having knowledge of biologically significant levels of PO-210 in its products, it could ignore PO-210 as a possible cause of lung cancer.”

Source: William Birnbauer, Theage.com.au

EU Unsure About Regulating Radioactive Polonium in Tobacco

Traces of polonium present in tobacco recently raised questions at the European Commission, while traces of radioactive and other substances – such as radon, polonium and cadmium – contained in tobacco leaves open questions as to whether they should be regulated at EU level.

Following media reports about the dangers of polonium contained in cigarettes, the Commission is studying whether or not the substance should be included in the list of regulated ingredients, a spokesperson for the EU executive told EurActiv.

Radioactive Polonium in CigarettesUp until now the EU has regulated additional substances found in tobacco products such as nicotine, tar and carbon monoxide, but did not take into account the tobacco leaf itself, running counter to World Health Organisation (WHO) recommendations.

Asked whether such highly dangerous radioactive and poisonous substance could be regulated at all, the Commission official responded that this was a difficult question to answer.

Tobacco firms knew about the presence of polonium in cigarettes and the dangers it involved, but the results of the research were not published for fear of “waking a sleeping giant”, according to Monique Muggli of Mayo Clinic in Minnesota, quoted in the September edition of the American Journal of Public Health.

Polonium 210 is a highly radioactive substance which has been found to cause lung cancer in 90% of cases. It is this very same substance which poisoned former KGB agent Alexander V. Litvinenko.

Regarding the relationship between polonium 210 and the radioactivity of cigarettes, Muggli said: “The companies wanted to hide from that issue publicly. They continue to minimize the recognition of radioactivity in their products in smoking and health litigation,” quoted in The Independent, a British daily.

So far, the Commission’s tobacco legislation has set limits on nicotine, tar and carbon monoxide yields to be applied in all member states. In line with this, the EU executive is putting pressure on the industry to add more visual warnings about the danger of smoking on cigarette packets themselves.

Source: The EurActiv network

Related Links

EU official documents

Press articles

Small Changes Can Help Prevent Cancer

Making small changes could make a big difference in preventing cancer.

Avoid preventable risk factors by incorporating these guidelines into of your lifestyle.

Three choices can make a vast difference in increasing your odds for staying healthy and keeping yourself in check.

Don’t Smoke Tobacco

Smoking damages nearly every organ in the human body, is linked to at least 15 different cancers, accounts for about 30 percent of all cancer deaths and costs billions of dollars each year, according to the American Cancer Society.

In the United States, cigarette smoking is responsible for about 90 percent of all cases of lung cancer — the leading cause of cancer death. Smoking cigars and pipes or chewing tobacco isn’t safe either.

“The importance of not smoking cannot be over emphasized in the prevention of cancer,” says Dr. Thomas Johnson, oncologist with Sacred Heart Medical Oncology Group. “Quitting is imperative for anyone who uses tobacco. Even people who have used tobacco for many years reduce their risk of cancer by quitting, as compared to people who continue to use tobacco.”

Toss Cigarettes Away“The predisposition for lung cancer does run in families,” Johnson says. “Smokers with relatives who have contracted lung cancer are at extremely high risk for developing cancer themselves, due to their genetic makeup.

You will often see multiple cases of lung cancer in a family that has a history of COPD, emphysema or lung cancer — those family members are predisposed to cancer and should not smoke.

Tobacco use alone increases their risk of cancer by 10 to 20 percent.”

Eat Healthy Foods and Get Regular Exercise

Fully one-third of cancer deaths are linked to poor diet, physical inactivity and carrying excess weight.

The American Cancer Society recommends that you limit foods high in fat, eat five or more servings of fruits and vegetables each day and limit alcohol, if you drink it at all. Include moderate physical activity (such as brisk walking) for at least 30 minutes on most days of the week to help achieve or maintain a healthy weight.

“Being overweight increases cancer risk by causing the body to produce and circulate more of the hormones estrogen and insulin, which can stimulate cancer growth,” said Dr. Dee McLeod, oncologist with Sacred Heart Medical Oncology Group. “Studies suggest that people whose diet is high in fat have an increased risk of cancers of the colon, uterus and prostate. Lack of physical activity and being overweight are risk factors for cancers of the breast, colon, esophagus, kidney and uterus.”

Avoid Harmful Sun Exposure

Most skin cancer occurs on exposed parts of your body, including your face, hands, forearms and ears. When going out in the sun keep these tips in mind: Avoid peak hours of the sun’s ultraviolet (UV) radiation between 10 a.m. and 4 p.m., stay in the shade, cover exposed skin with clothes and hats and use sunscreen that has a sun protection factor (SPF) of at least 15.Get immunized

Certain cancers are associated with viral infections that can be prevented with immunizations. Talk to your doctor about immunization against Hepatitis B and the Human Papilloma Virus.

Get Health Screenings

“For many types of cancer, by the time that there are symptoms, the cancer is too far advanced to achieve a cure,” McLeod says. “Cancer screenings identify those at high-risk for cancer, and to be most useful, must detect cancers before symptoms would cause a person to seek care. Early detection is so often a key factor in successful treatment.”

Screenings should include tests to detect cancers of your skin, mouth, colon and rectum. If you’re a man, it should also include your prostate and testes. If you’re a woman, add cervix and breast cancer screening to your list. Visit www.cancer.org to find the American Cancer Society Guidelines for Early Detection of Cancer.

For more information on cancer prevention and treatment, visit The SacredHeart Cancer Center.

Toenails Reveal All

Your toes tell it all, ladies.

Toenail clippings can provide evidence of tobacco exposure and help explain the risk of heart disease, at least in women, according to a unique study from the University of California-San Diego and Harvard University.

The medical researchers examined levels of nicotine in toenails of 905 women who were diagnosed with coronary heart disease from 1984 through 1998.

The women were among the 62,641 participants in the Nurse’s Health Study. Those with heart disease were randomly matched to two other participants by age and by the date that their toenails were collected.

The twenty percent of women who had the highest nicotine levels in their toenails turned out to have more than triple the risk of being diagnosed with heart disease as those whose levels put them in the lowest twenty percent. The risk remained significantly higher after the researchers took smoking into account, adjusting for the number of cigarettes smoked as well as exposure to second hand smoke.

Women's Toenails“Using toenail nicotine is a novel way to objectively measure exposure to tobacco smoke, and ultimately, to increase our understanding of tobacco-related illness, said Wael Al-Delaimy, of UC-San Diego’s department of family and preventive medicine, lead author of the study published this month in the American Journal of Epidemiology. “This would be especially helpful in situations where smoking history is not available or is biased.”

Source: Josh Goldstein, The Philadelphia Inquirer

Quitting Smoking is a Pack Behavior

Smokers tend to quit in groups, according to a new study.

One person who quits can have ripple effects across his or her entire social network, prompting others to kick the habit.

The New York Times offers this delightfully evocative explanation of how the process works:

As the investigators watched the smokers and their social networks, they saw what they said was a striking effect — smokers had formed little social clusters and, as the years went by, entire clusters of smokers were stopping en masse. So were clusters of clusters that were only loosely connected.

Dogs in a FieldStudy co-author Dr. Nicholas Christakis described watching the vanishing clusters as like lying on your back in a field, looking up at stars that were burning out. “It’s not like one little star turning off at a time,” he said. “Whole constellations are blinking off at once.”

Continue Reading About the Stop Smoking Ripple Effect

A Bachelor’s Degree for Quitting Smoking?

For Nora King, a former chain-smoker with a master’s degree, it was neither a harrowing visit to her doctor nor a disturbing news article on the latest findings about the damage of cigarettes that caused her to put down her smokes once and for all.

It was a television commercial she saw a year ago in her New York City apartment that vividly illustrated what goes on inside a smoker’s body that made her decide to try to quit though a new study suggests the academic work she did years ago may have helped, too.

“The commercial showed the white stuff that builds up in smokers’ arteries,” King, 44, said. “It was really graphic and gross, and I would turn my head every time it came on.”

Visual images in stop-smoking ads have been a mainstay of stop smoking campaigns for years, but researchers at the University of Wisconsin recently found they may be more effective helping those with a college degree than those with a high school diploma or only some college.

“Smoking rates have declined steadily since 1966 for college-educated smokers with some college, but they have declined far more slowly for people who have high school, and we wanted to know why that is,” said Dr. Jeff Niederdeppe, a researcher at the University of Wisconsin’s department of population health sciences and an author of the study.

Cigarette smoking has declined among adults in the United States from about 42 percent of the population in 1965 to about 21 percent in 2005 (the latest year for which numbers are available), according to the American Cancer Society. Figures from the society’s Web site show that about 45 million adults currently smoke cigarettes – and 24 percent of men and 18 percent of women are smokers.

For their study, Niederdeppe’s team interviewed a representative sample of smokers: some who had a college degree, some who had some college experience, and some who had a high school diploma.The smokers all saw stop smoking ads, and a year later, the research team then came back and interviewed the same group to see who had tried to quit and who had been able to quit in that period.

“Some type of media messages were less effective for people with lower levels of education,” Nierderdeppe said, “but we weren’t able to say definitively why that is.”

He said that the greatest discrepancy between groups trying to quit occurred based on the type of ad that encouraged the smoker to keep trying to quit, even though it’s hard, and they can call a helpline for support.

“We saw a big difference between education levels for the keep-trying-to-quit ads,” Niederdeppe said.

A reason Americans without a college degree responded less to the stop smoking ads is because education is tied to socioeconomic status and less-educated smokers may have less access to quit resources and may be less likely to be given medications to quit, Niederdeppe said.

The essence of the ads that college-educated smokers responded to, “If you keep trying to quit, you can do it,” may not be true for smokers who are in a lower socioeconomic status, said Niederdeppe.

“This message may not resonate with their experience,” he said. “Higher educated people have much more resources, social resources, and environments that restrict smoking.”

Nancy DiMartino, 61, who has some college but no degree, said commercials haven’t helped her quit.

“There’s an old saying: nothing scares an addict,” she said.

Picture of Graduation CapDiMartino, a former transcribing legal secretary who took several college credits to become certified, said, cigarettes help her deaden her emotions, so she’s out the door to the store to buy cigarettes as soon as she feels a negative emotion coming on.

“Cigarettes numb me out like alcohol does for an alcoholic, or drugs do for a drug addict,” she said.

Although her father died of emphysema, DiMartino said that the powerful chokehold nicotine has on her, physically as well as mentally, has made quitting a seemingly impossible task.

She successfully managed to quit for five years, but it didn’t last. One recent Christmas Eve, after she lost her job with a government agency, she was mugged.

The stress proved to be too much, and DiMartino picked up where she had left off.

Even when one of her grandchildren saw her smoking and began to cry, begging her to stop smoking, she has been unable to leave the habit behind for a second time.

DiMartino knows what kind of danger she is putting herself in by continuing to smoke.

“I have carpal tunnel syndrome and it’s getting worse,” she said. “I know I could wind up on an oxygen tank. But whenever I see those ads, I think that this could never happen to me,” she said.

Source: The Modesto Bee
Original source: Jessica Freiman, Columbia News Service

Smoking Reversible?

Risk of death from tobacco related diseases or various forms of cancer declines dramatically five years after kicking the habit.

Women who quit smoking reduce their risk of dying from heart disease and tobacco-related cancers.

Researchers at the Harvard School of Public Health analyzed data on 105,000 women over 24 years, taken from the Nurses’ Health Study, a long-term survey that began at Harvard in 1976.

Stacey Kenfield is lead author of the new report. She says the data show harm from smoking can be reversed over time to the level of a non-smoker. “For coronary heart disease for example, your risk declines to a non-smokers’ risk within 20 years. For all causes it declines at 20 years. For lung cancer it is after 30 years.”

Kenfield says scientists observed almost immediate benefits when the women kicked the habit. “We saw a 47 percent reduction in risk for coronary heart disease within the first five years [of quitting] and a 21 percent reduction in lung cancer death within the first five years.” Kenfield says the data also indicate that smoking is more dangerous the younger a woman is when she starts. “If you start before you are 17, you have a 21-fold higher risk than a non-smoker. But if you start after the age of 26 you only have a 9-fold higher risk of dying from lung cancer.”

Picture of Girl SmokingBased on that evidence, Kenfield recommends high schools offer more programs to help students quit. “If you would like to see the whole potential benefit from your cigarette cessation, you really need to quit as soon as possible.”

Tobacco is the leading preventable cause of death in the United States. The World Health Organization attributed 5 million deaths to smoking in 2000. That number is expected to climb to 10 million tobacco-related deaths by 2030. Kenfield’s study is published in the Journal of the American Medical Association.

Source: Voice of America News

Toddlers Most Affected by Second Hand Smoke

Second hand smoke in the home appears to induce markers for heart disease as early as the toddler years.

Researchers reported this news at the American Heart Association 48th Annual Conference on Cardiovascular Disease Epidemiology and Prevention in March.

It has long been known that many forms of cardiovascular disease in adults are initiated and progress silently during childhood. Now researchers have found a young child’s response to smoke may not just affect the respiratory system, but the cardiovascular system as well.

“This is the first study that looks at the response of a young child’s cardiovascular system to secondhand smoke,” said Judith Groner, MD, lead author of the study, pediatrician and ambulatory care physician at Nationwide Children’s Hospital and Research Institute in Columbus, OH.The study included 128 children, 2 to 5 years old and adolescents between the ages of 9 and 14. Researchers found that the younger children absorbed six times more nicotine than the older children from the same levels of parental smoking. That exposure resulted in a dramatic increase of markers of inflammation and vascular injury signaling damage to the endothelium, the inner lining of the vessel walls.

Hair samples of the younger children had average nicotine levels of 12.68 nanograms per milligram of hair compared to adolescent group, which had 2.57 nanograms per milligram of hair. Toddlers had significantly higher levels of the inflammatory marker soluble intracellular adhesion molecules (ICAM).

“Toddlers in the homes of smokers not only had higher levels of nicotine, but also had higher levels of markers for cardiovascular disease in the blood,” said John Bauer, PhD, senior author of the study and director of the Center for Cardiovascular Medicine at Nationwide Children’s Hospital. “The dose of smoke is greater in toddlers than adolescents who are able to move in and out of the home. Toddlers are like a fish in a fishbowl. They are exposed at a higher dose. And it appears that toddlers also are more susceptible to the cardiovascular effects of smoke.”

Toddlers and a Fish BowlMost of the children in the study had varying levels of secondhand smoke exposure, measured by the number of adult smokers a child was exposed to in 24 hours. Researchers took hair samples to determine nicotine levels in the body and drew blood to determine endothelial progenitor cell (EPC) levels by flow cytometry. Endothelial progenitor cells replenish the endothelium and serve as a biological marker for vascular function.

Researchers also measured known inflammatory markers, such as ICAM, in the blood. “When we analyzed our data by looking at the relationships between the number of smokers in the home and the EPC levels, we found that in toddlers, there was an inverse relationship between secondhand smoke exposure and EPC prevalence,” Dr. Groner said. “In other words, the more smokers the toddler was exposed to, the fewer EPC cells were circulating in his bloodstream. This relationship was not present among the adolescents.”

The vascular endothelium (the inner lining of arteries and blood vessels) plays a key role in promoting cardiovascular health by maintaining the tone and circulation of the arteries. ICAM is a specific marker of endothelial cell stress, which contributes to artery clogging and atherosclerosis, raising the risk of heart disease.

“The combustion of the cigarettes appears to be causing endothelial damage which is reflected in the increase in soluble ICAM in exposed children,” Dr. Groner stated. “Toddlers who are in the vicinity of smokers in the home have a higher dose of tobacco chemicals. They live at home and can’t escape. Young children also breathe faster, taking more smoke into their respiratory system.”

Past studies found that the levels of EPC are lower in adult smokers. EPCs have not been studied previously in non-smokers who are exposed to secondhand smoke.

This study indicates that cardiovascular effects of tobacco exposure in children are very similar to that of adults in the affect on the vascular wall, Dr. Groner said.

She noted the study is a “snapshot in time” and doesn’t give a long-term picture of the effects of secondhand smoke on the developing cardiovascular system of children.

“The results are intriguing, but further study is needed,” she said. “We’re not sure what happens to kids if they stay in a smoking environment or if they have multiple risk factors such as being overweight or having high blood pressure. Until then, parents and others should not smoke in homes with children, and should be especially attentive to this issue around toddlers.”

Other study authors were: Hong Huang, MD, PhD; Lisa Nicholson, PhD; Danielle Frock; Catherine Schroeder; and Jennifer Kuck, ACSM.

The Flight Attendant Medical Research Institute (FAMRI) funded the study.

Source: Advance