Health and Secondhand Smoke

Adopted by the Executive Board of the North Carolina Council of Churches, September 5, 2006

Background

In 1984, the North Carolina Council of Churches issued a report entitled “The Moral Dimensions of Tobacco.” This report, the product of a year-long study, concluded that “the evidence of the medical community [is] convincing,” with “[m]edical data certifying the negative effects of the use of tobacco.” As hard as it may be to believe today, the report made national news, for we were the first statewide, non-medical organization in North Carolina to agree with the premise that tobacco use actually had harmful health ramifications. Since then, the Council has supported legislation making it more difficult for underage youth to purchase cigarettes and increasing the cigarette tax enough to discourage young people from beginning to smoke.

Even in 1984, the Council’s report suggested that there were “harmful effects . . . to those non-smokers exposed to the side-smoke of smokers.” Today, an increasingly strong body of research points to the fact that secondhand smoke (that which is inhaled by non-smokers in a smoking environment) does indeed pose serious health hazards. This risk is associated not only with long-term consumption but also with secondhand smoke breathed in for as little as thirty minutes.  Consider the following:

• Non-smokers exposed to secondhand smoke have been shown to have many of the same tobacco-related diseases as active smokers. Secondhand smoke has been shown to increase non-smokers’ risk of heart disease, stroke, and cancer and to cause lung and nasal cancer in nonsmoking adults.[1] Non-smokers routinely exposed to secondhand smoke at work see their risk of lung cancer increase by at least 50%.[2]
• As little as thirty minutes of exposure can trigger a heart attack in someone with heart disease or risk factors for heart disease. The Centers for Disease Control and Prevention (CDC) warns that “. . .all patients at risk of coronary heart disease or with known coronary artery disease should be advised to avoid all indoor environments that permit smoking.”[3]
• Community restrictions on smoking in public places have reduced the incidence of heart attacks among bartenders by 40%.[4]
• According to the National Cancer Institute and the Environmental Protection Agency, young people exposed to secondhand smoke are at increased risk for lower respiratory infections, chronic ear infections, asthma, abdominal obesity, and hyperglycemia[5] and can have impaired ability to learn, including reading deficits and deficits in math and reasoning.[6]
• Pregnant women exposed to secondhand smoke are at increased risk of having low birth-weight babies.[7]
• The American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) is the international standard-setting body for a number of engineering practices, including ventilation. According to ASHRAE, ventilation and other air filtration technologies cannot eliminate all the health risks caused by secondhand smoke exposure, and because there is no safe level of exposure to secondhand smoke, tobacco smoke does not belong in indoor areas.[8]

An Issue for People of Faith

In our 1984 report, we grounded our concern about the health impact of tobacco use on two biblical teachings. The first is that our bodies are God’s temples (1 Cor. 6:19-20). Therefore, “[i]f tobacco is injurious to one’s health, it becomes (along with alcohol, illegal drugs, overeating, etc.) a viable area of concern for Christians.” The second is that Christians should not be stumbling blocks for our brothers and sisters (Rom. 14.21). In 1984, that led us to say “If the use of tobacco by others is injurious to their health, then our production, advertising, and modeling of its use must be of concern to Christians.” Today we would add that, since secondhand smoke also causes harm, we become stumbling blocks if we permit this harm to co-workers in our offices, laborers in our factories, servers in our restaurants, and fellow members of our congregations.

This concern for our health and the health of others also flows from broad teachings of our faith. We follow a religious leader whom we still call The Great Physician. Forty percent of the narratives in the gospels are about healing and health. We follow Jesus’ call to bring healing and wholeness to people. Because of this, we have built hospitals, trained doctors and nurses, sent medical missionaries around the world, created free clinics, hired parish nurses, and used our congregations as wellness centers. And, because of this, we must speak out and take action regarding the harmful effects of secondhand smoke.

Recommendations

Our concern, as people of faith, for the health consequences of smoking has only deepened in the twenty-two years since our first statement. Today we call for the following steps to prevent further illness and death from secondhand smoke:

• We endorse legislation that would ban smoking in all worksites and public places.
• We affirm those many congregations which have prohibited smoking on church grounds, and we call on all other congregations to study the research on secondhand smoke. We encourage congregations which do not have a judicatory-based program to participate in the Tobacco-Free Church Grounds program of the Center for Health and Healing, which is affiliated with the General Baptist State Convention of NC.
• We renew our endorsement of legislation which would end “preemption,” a law under which local governments are currently forbidden from adopting smoking restrictions more stringent than the state’s weak smoking regulations (which, when introduced in 1993, actually required most state facilities to have smoking areas).
• We support funding for smoking cessation programs, especially for low income individuals.

[1] National Cancer Institute. Health Effects of Exposure to Environmental Tobacco Smoke. Smoking and Tobacco Control Monograph No. 10. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 1999.

[2] Shopland, D.R.; Anderson, C.M.; Burns, D.M.; Gerlach, K.K., “Disparities in smoke-free workplace policies among food service workers,” Journal of Occupational and Environmental Medicine, 46(4): 347-356, April 2004.Siegel, M. “Involuntary Smoking in Restaurant Workplace: A Review of Employee Exposure and Health Effects.” JAMA, 270:490-493, 1993.  Johnson KC, Hu J, Mao Y. Lifetime residential and workplace exposure to environmental tobacco smoke and lung cancer in never-smoking women, Canada 1994-97. Int J Cancer. 2001 Sep;93(6):902-6.

[3] Pechacek, TF and Babb, S, How acute and reversible are the cardiovascular risks of secondhand smoke? BMJ. 2004 Apr 24;328(7446):980-3.

[4] Sargent, RO, Shepard, RM and Glantz, SA, Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ 2004 328: 977-980. CDC – MMWR – Dec 24, 2004.

[5] U.S. Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, DC: US Environmental Protection Agency; 1992, Pub. No. EPA/600/6-90/006F.

[6] Yolton, K. et al., “Exposure to Environmental Tobacco Smoke and Cognitive Abilities of U.S. Children and Adolescents,” Environmental Health Perspectives, 113(1): 98-103.

[7] US Department of Health and Human Services. Women and smoking: a report of the Surgeon General. Washington, DC: US Government Printing Office, 2001.

[8] Samet, J.; Bohanon, Jr., H.R.; Coultas, D.B.; Houston, T.P.; Persily, A.K.; Schoen, L.J.; Spengler, J.; Callaway, C.A., “ASHRAE position document on environmental tobacco smoke,” American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), 2005.