• Setting the Record Straight: Secondhand Smoke is A Preventable Health Risk
  and Respiratory Health Effects of Passive Smoking
  United States Environmental Protection Agency

In 1993, the U.S. EPA published a major report on the effects of second-hand smoke, based on a thorough review of all the scientific literature. The agency went on to classify second-hand tobacco smoke as a Group A human carcinogen. In response, the tobacco industry launched a major campaign to discredit the environmental regulator, through the media, political lobbyists and the courts.

In July 1998, a U.S. District Court judge in North Carolina ruled that the EPA had failed to follow scientific procedure in reaching its conclusions about the link between cancer and second-hand smoke.

The decision is under appeal. Since the original report was published, several other panels of scientists in other countries have come to the same conclusions: second-hand smoke is a killer.

• International Consultation on Environmental Tobacco Smoke (ETS) and Child Health - 11-14 January 1999 - Geneva, Switzerland
  Consultation Report
  World Health Organization

Executive Summary

The Consultation concluded that ETS is a real and substantial threat to child health, causing death and suffering throughout the world. ETS exposure causes a wide variety of adverse health effects in children, including lower respiratory tract infections such as pneumonia and bronchitis, coughing and wheezing, worsening of asthma, and middle ear disease. Childrens' exposure to environmental tobacco smoke may also contribute to cardiovascular disease in adulthood and to neurobehavioural impairment.

The Consultation also concluded that maternal smoking during pregnancy is a major cause of sudden infant death syndrome (SIDS) and other well-documented health effects, including reduced birth weight and decreased lung function. In addition, the Consultation noted that ETS exposure among nonsmoking pregnant women can cause a decrease in birth weight and that infant exposure to ETS may contribute to the risk of SIDS.

• Report of the Scientific Committee on Tobacco and Health (SCOTH)
  Department of Health, UK (1998)

Conclusions:

Exposure to environmental tobacco smoke is a cause of lung cancer and, in those with long term exposure, the increased risk is in the order of 20-30%.

Exposure to environmental tobacco smoke is a cause of ischaemic heart disease and, if current published estimates of magnitude of relative risk are validated, such exposure represents a substantial public health hazard.

Smoking in the presence of infants and children is a cause of serious respiratory illness and asthmatic attacks.

Sudden infant death syndrome, the main cause of post-neonatal death in the first year of life, is associated with exposure to environmental tobacco smoke. The association is judged to be one of cause and effect.

Middle ear disease in children is linked with parental smoking and this association is likely to be causal.

• California Environmental Protection Agency Office of Environmental Health Hazard Assessment. Health Effects of Exposure to Environmental Tobacco Smoke. (1997)

The long and the short of scientific evidence about the negative effects of second-hand smoke. In November 1999, this report was republished as a monograph of the U.S. National Cancer Institute (see Monograph 10).

• The health effects of passive smoking
  A Scientific Information Paper - November 1997
  Australian National Health and Medical Research Council

Another overview of the scientific evidence on second-hand smoke.