Even before the Surgeon General’s 1964 report, “Smoking and Health,” society has been aware of the terrible effects of tobacco smoke on health. Today, you’d have to be living under a rock or purposely obtuse to not know that tobacco smoke is a very dangerous pollutant. Whether you’re doing the smoking yourself or just enduring exposure to side-stream smoke or second hand smoke, tobacco smoke contributes to lung cancer, emphysema, heart disease and other illnesses. The chemical cocktail of lethal compounds in tobacco smoke cause the oxygen levels in your blood stream to drastically lower, prohibiting normal function of your body.
Side-stream Smoke vs. Second-hand Smoke
While second-hand smoke is released from the exhale of the person smoking, side-stream smoke is released directly from the burning paper and tobacco. Side-stream smoke is more toxic than second hand smoke! The combination of second-hand and side-stream smoke make the “no smoking zone” a pipe dream. The Nevada Clean Indoor Air Act was a non-comprehensive smoke-free law that permitted limited smoking in casinos as long as a “no smoking” area was implemented. Well, a follow-up study sampled the air quality in 15 casino gaming areas, both smoking and non-smoking areas. Results showed that the policy failed to preserve indoor air quality in the no-smoking, children-friendly areas. Analysts concluded that adopting a more comprehensive, 100% smoke-free policy was the only effective remedy. 
Tobacco smoke smells bad and is clingy. Gone with the wind? Not quite. When you smoke, it infiltrates your air, clothing, hair and skin with contaminated chemicals and it seems to hang around forever. A study in Singapore found that at least 4-6 hours of purging time was necessary to only minimize environmental tobacco smoke exposure to non-smokers when entering a smoking room.  That’s a hard bar to meet when the concentration of cigarette smoke reaches epic proportions and never stops, like in a casino.
Air Quality Considerations
- A common cigarette contains 4,000+ chemicals including ammonia, butane, arsenic, lead, and benzene.
- Smoking a pack of smokes a day for a year can put a quart of tar in your lungs.
- Second-hand and side-stream smoke includes 35+ carcinogenic chemicals.
The Surgeon General’s report in 2006 stated:
- Second-hand and side-stream tobacco smoke have a negative health effect for everyone exposed.
- Second-hand or side-stream smoke exposure increases your likelihood of heart disease and lung cancer.
- Second-hand and side-stream smoke have been related to Sudden Infant Death Syndrome (SIDS) and advanced infections and asthma in babies and children.
- Over half of all reported disease are caused or worsened by toxic indoor air, including tobacco smoke.
- Indoor air may be 10 times more toxic than outdoor.
Legislation isn’t the Full Answer
We must be aware that policies don’t always extend to pragmatic realities. The University of California San Francisco School of Nursing found that, despite tobacco-control policies in California, people continue to be exposed to second-hand smoke. They attributed a lack of full compliance to smoke-free work place laws as part of the problem as well as exposure in the home. 
The anti-smoking sentiment has also not yet spread across the world. The Department of Health Behavior at the Roswell Park Cancer Institute in Buffalo, NY notes that although smoke-free policies have been an important and high-profile intervention in America, only 11% of the world’s population live in countries with smoke-free laws. 
An evaluation of Spain’s anti-smoking legislation found that though eliminating smoking from indoor areas is highly effective, second-hand smoke still has a tendency to drift indoors when smoking happens outside entrances. This is often why smoking bans in the United States include an immediate area around building entrances. Considering outdoor restrictions to ensure complete protection against SHS may be appropriate. 
How To Reduce Your Exposure
Serbia’s Public Health Institute found tobacco smoke to have an effect on children that can only be described as an urgent problem with life lasting negative health effects- which are preventable!  How? The U.S. Clean Air Council suggests the following tips to help eliminate tobacco pollution from your home and environment:
- Quit smoking, now.
- Only visit smoke-free establishments, let them know you support them.
- Open windows and encourage ventilation.
- Remove smoke-infused wallpaper.
- Remove tobacco-infused carpet.
- Replace all heating and air filters regularly.
- Get a high-quality, indoor air purification system.
If you smoke, stop. Listen, there are plenty of ways to put a band-aid on the ugly sore of smoking to minimally counteract it, but quitting is the only sure way to promote a healthy future for you and your family. It’s a tough process but can be done. Set a goal and achieve it, then reward yourself. Protect the health of your family and yourself by implementing a “no-tobacco” policy in your own home. Encourage others to do the same.
by Dr. Edward Group DC, NP, DACBN, DCBCN, DABFM
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