Blood tests reveal tobacco
smoke residues in non-smoking New Yorkers
Wednesday, April 8,
2009
More than half of non-smoking New Yorkers have elevated levels of
cotinine in their blood – meaning that they were recently exposed
to toxic second-hand smoke in concentrations high enough to leave
residues in the body. Cotinine, a by-product of nicotine breakdown,
is not harmful itself but signals exposure to environmental tobacco
smoke. A Health Department study, published online this week in the
journal Nicotine and Tobacco Research, shows that 57% of adult New
Yorkers (2.5 million) have elevated cotinine levels, compared to
45% of adults nationwide – a finding that may reflect the city's
dense, urban character. Second-hand smoke contains many harmful
chemicals. It is known to cause cancer and heart disease in adults,
as well as serious health problems for children.
The data come from the New York City Health and Nutrition
Examination Survey, which was conducted in 2004, one year after New
York City's smoke-free air law took effect. Although the law
protects non-smokers from the dangers of second-hand smoke at work
and in some public places, this study shows that many non-smokers
are not fully protected. Creating a smoke-free home is the most
important step that New Yorkers can take to protect their
families.
"Tobacco smoke is a toxic pollutant," said Dr. Thomas R. Frieden,
New York City Health Commissioner. "Most New York City non-smokers
are breathing in dangerous chemicals in second-hand smoke,
potentially increasing the risk of cancer and heart disease.
Households with a smoker should set a 'no smoking' policy at home
to protect the family. We encourage all New Yorkers who smoke to
quit – this is the best way to protect yourself and others."
"The study provides more evidence of the pervasiveness of
second-hand smoke," said Jennifer Ellis, PhD, a former Health
Department epidemiologist and the study's lead author. "It's not
clear why New Yorkers experience more exposure, despite the city's
relatively low smoking rate. It may be that living and working in
close quarters with one another puts us at higher risk."
On sidewalks, including near building and subways entrances,
non-smokers are still exposed to tobacco smoke unavoidably. The
federal government has adopted regulations prohibiting smoking
within 25 feet of federal building entrances to address complaints
and health concerns; other cities and states have similar
regulations for all buildings.
Among non-smoking New Yorkers, Asian adults were the most likely to
have elevated cotinine levels (69%). Studies from other parts of
the country show that Asian Americans, particularly Chinese
Americans, are more likely to smoke at home. Lower-income New
Yorkers were also more likely to be exposed than those with higher
incomes (63% versus 54%).
This is the first time researchers have used blood tests to gauge
second-hand smoke exposure in New York City, so it is not possible
to say whether cotinine levels have increased or decreased over
time.
The Health Department is currently airing two educational public
service announcements on television highlighting the effect of
smoking on one's family. One campaign, called "Cigarettes Are
Eating You and Your Kids Alive," depicts the effects of second-hand
smoke on children. It was originally aired in 2008. The graphic
images remind viewers that second-hand smoke makes children more
susceptible to pneumonia and ear infections, and contributes to
lifelong health conditions such as asthma. The agency is
simultaneously airing "Separation," which shows a little boy crying
in a train station after momentarily losing his mother – a moment
meant to give a glimpse at the pain of losing a parent for life
from a smoking-related death.
The facts about second-hand smoke
-Second-hand smoke is toxic. Non-smokers who live with second-hand
smoke are more likely to suffer from cancer and heart disease.
Women who live with second-hand smoke are more likely to have
low-birth-weight babies, pre-term delivery and miscarriage.
-Second-hand smoke is especially bad for children. When parents
smoke, babies are more likely to die from Sudden Infant Death
Syndrome (SIDS). Children have more illnesses, including ear
infections and asthma. Teens are more likely to become smokers
themselves.
-There is no risk-free level of exposure to second-hand
smoke.
What to do to reduce your exposure or protect your
family
-Make your home smoke-free. For more information, read How to Make
Your Home Smoke-Free.
-If you smoke, quit. This is the best way to protect your family.
If you need help quitting, try nicotine replacement therapy
(patches or gum), which can double your chances of quitting
successfully. Call 311 for more help.
Key Health Department anti-tobacco efforts
There are more than 300,000 fewer adult smokers in New York City
than in 2002 – a 21% decline in adult smoking. Youth smoking has
declined by 52% during the same period. The Health Department works
to reduce tobacco use through these and other efforts,
including:
-Anti-smoking educational campaigns that illustrate the dangers and
consequences of smoking and the benefits of quitting.
-Nicotine replacement therapy giveaways, which significantly
increase smokers' likelihood of quitting for good. The agency gives
away approximately 60,000 kits each year.
-Enforcing the Smoke-Free Air Act, which protects New Yorkers from
the harmful effects of second-hand smoke at work. Compliance
remains high, at 95%.
About the data
Cotinine levels were assessed through the New York City Health and
Nutrition Examination Survey, which is modeled after the National
Health and Nutrition Examination Survey (NHANES). The Health
Department assessed a variety of health issues, ranging from
diabetes to depression, by visiting households to gather
information. Researchers conducted face-to-face interviews,
physical exams and laboratory tests. The survey was conducted in
2004 among a representative sample of New York City adults age 20
or older. Of the 1,999 people enrolled in the survey, 1,767 (88%)
were tested for cotinine levels.
Cotinine is present in the blood of people who recently smoked or
inhaled second-hand smoke; it is present in lower levels in
non-smokers than smokers. People with a level greater than 10
nanograms per milliliter of blood (ng/mL) are considered smokers,
while people with levels 10 ng/mL or less are considered
non-smokers who were recently exposed to tobacco smoke. An elevated
cotinine level is defined as .05 ng/mL or more.
###
New York City Health Department
Thanks to New York City Health
Department for this article.