Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence

Heart disease is the leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC). An American has a coronary event (heart attack) nearly every 25 seconds, resulting in death about every minute. Smoking is the leading risk factor for heart disease. Evidence suggests that exposure to secondhand smoke also can result in adverse health effects, including heart disease in nonsmoking adults. Secondhand smoke, also known as environmental tobacco smoke, consists of a mixture of gases and particles including smoke from burning cigarettes, cigars, pipe tobacco, and exhaled mainstream smoke. Smoking bans are making progress at reducing involuntary exposure to secondhand smoke in workplaces, restaurants, and other public places in the United States and abroad. Such legislation also provides the opportunity to study the effects of smoking bans on the health of smoking and nonsmoking adults. In 2008, the CDC asked the Institute of Medicine to convene a committee to assess the relationship between secondhand-smoke exposure and effects on the heart. The committee evaluated three relationships: The association between secondhand-smoke exposure and cardiovascular dis• ease The association between secondhand-smoke exposure and acute coronary • events (heart attacks) The association between smoking bans and heart attacks •