-Caveat Lector-
The Philadelphia Inquirer, August 18, 1999
Secondhand smoke linked to stroke risk
A New Zealand study found that so-called passive smokers were much more likely
to suffer strokes.
By Emma Ross
ASSOCIATED PRESS
LONDON - Breathing in other people's cigarette smoke makes nonsmokers 82
percent more likely to suffer a stroke, a new study suggested yesterday -
indicating that the dangers of so-called passive smoking are much worse than
originally believed.
The study by researchers at the University of Auckland in New Zealand is the
largest and most rigorous to date, and gives more ammunition to those
campaigning to have smoking banned in all workplaces and public areas.
Current estimates of how smoking increases the risk of various diseases are
dramatically underestimated because the ill effects of secondhand smoke are
not taken into account, say the researchers, whose work is published in the
British medical journal Tobacco Control.
That means research into the hazards of tobacco smoke has artificially
narrowed the true gap between smokers and people whose bodies really are
tobacco-free, said Rodney Jackson, a professor of epidemiology at the
University of Auckland and one of the authors of the study.
"We've never really had the right comparison group because everybody has been
slightly poisoned," Jackson said.
Because New Zealand's anti-passive-smoking legislation is among the toughest
in the world, it was easier to single out people who have been exposed to
secondhand smoke, he said.
Two previous studies have linked strokes with secondhand smoke. Studies also
show that passive smoking increases the risk of heart disease, heart attack,
lung and breast cancer, and breathing-related diseases.
The suggestion that studies of the dangers of smoking underestimate the real
risk is "an important point that has not been well-appreciated," said Stanton
A. Glantz, a secondhand-smoke expert at the University of California-San
Francisco who was not connected with the study.
The study examined 521 stroke patients in Auckland and compared them with
1,851 randomly selected healthy people matched by sex and age to see the
effect of smoking and secondhand smoke on the chances of suffering a stroke.
None of the subjects was older than 74.
"Half the people who have strokes are 75 or older, so these are premature
strokes that should not be happening," said Ruth Bonita, the lead author of
the study, who now runs the non-communicable-disease section at the World
Health Organization.
Anyone who smoked at least one cigarette a day was termed a smoker. Those who
had never smoked or had not smoked for at least a decade were considered
nonsmokers. Other former smokers were divided according to how long it had
been since they stopped.
People were classified as having been exposed to secondhand smoke if they
lived with or worked in the same room as someone who regularly smoked in front
of them for more than one year during the last 10.
The fewer cigarettes people smoked each day, and the longer ex-smokers had
abstained, the better off they were, but the difference between them and
nonsmokers was not as dramatic once secondhand smoke was taken into account.
Overall, smokers were four times more likely to suffer a stroke than
nonsmokers. But when the nonsmokers exposed to secondhand smoke were excluded
from the equation, smokers were six times more likely to have a stroke. That
is a difference of about 50 percent.
Also in the basic investigation, people who had quit smoking more than two
years before were no more likely to suffer a stroke than those who had never
smoked. But once the passive-smoking factor was removed, those people still
had nearly double the chance of suffering a stroke.
Lifetime nonsmokers and those who had quit smoking more than a decade earlier
were 82 percent more likely to have a stroke if they were breathing secondhand
smoke.
Men fared worse, with a doubling of their stroke risk, compared with a 1.5
times increased chance for women.
� 1999 Philadelphia Newspapers Inc.
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Robert F. Tatman
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