How would you feel if the government told you that you couldn’t smoke in your own car? Perhaps you’d endorse the idea that public health officials were trying to make it harder for people to maintain a habit that increases their risk of developing lung cancer, emphysema, heart disease and a host of other problems. Maybe you’d rejoice that you’d never again be forced to carpool to a meeting with a chain-smoking colleague.

You might even breathe a sigh of relief for all the children of smokers who would be able to ride to school, soccer practice and piano lessons without being forced to inhale clouds of secondhand smoke.

And some of you – smokers or not – might be more than a tad annoyed at the prospect of Big Brother dictating what you can and cannot do in the privacy of your own vehicle.

No law forbidding all smoking in cars is on the horizon in the U.S. (where a good many people get worked up about proposals to encourage healthy eating by imposing so-called fat taxes on soda, fried foods and the like). But drivers in the United Kingdom may be restricted from lighting up behind the wheel – if the country’s doctors have their way.

A report released Wednesday from the British Medical Assn.’s Board of Science calls on governments in the U.K. to impose a ban on smoking in vehicles as part of its overall effort to “achieve a tobacco-free society by 2035.” Over there, it is already against the law to smoke in buses, taxis and other public vehicles. Extending those rules to private vehicles could be done in one of three ways, the BMA suggests:
The ban could apply only to cars carrying children.
The ban could apply to any car with a passenger of any age.
The ban could apply to all vehicles at all times. (This is the option favored by the doctors, in part because it would be simplest to understand and enforce, they say.)
Why do they care? One of the primary reasons is to cut down on people’s exposure to secondhand smoke, which is especially concentrated inside a vehicle. “Tobacco smoke contains 4,000 known chemicals, 69 of which are known or probable carcinogens,” according to the 19-page report. Experts estimate that 23 children and 4,000 adults die in Britain every year because of the health effects of secondhand smoke.

A secondary concern is that fiddling with a cigarette is a dangerous distraction for drivers. Police in Britain are already empowered to write tickets for drivers if smoking is preventing them from driving safely.

Smoking rates in Britain are a little higher than they are in the U.S. (the U.S. Centers for Disease Control and Prevention says that 20.6% of Americans were smokers in 2009). According to the BMA, 21% of adults in England are smokers, along with 23% of adults in Wales, 24% of adults in Scotland and 24% of adults in Ireland. Three out of 10 smokers say they sometimes have a cigarette while driving.

Recent polls show some support for the doctors’ proposal – 88% of people in Ireland and 74% of people in England said they were in favor of a ban on smoking in cars carrying children. In addition, a report out last year from the Royal College of Physicians found that 56% of people in Britain support a blanket prohibition on smoking in vehicles.

An all-out ban would appear to be a first, but other countries do prohibit smoking in vehicles under some circumstances. In South Africa, it’s illegal to smoke in a car if any passengers are under the age of 12; five of Australia’s six states ban smoking in cars carrying children or teens (different states have different age cutoffs). In California, smoking is not allowed if any passengers are younger than 18.

Children are especially vulnerable to secondhand smoke because they take more breaths than adults, their immune systems aren’t fully developed, they’re “more vulnerable to cellular mutations” and they “absorb more pollutants because of their size,” according to the BMA.

The report notes that the Tobacco Manufacturers’ Assn. (which represents the British tobacco industry) is opposed to a complete ban. They prefer that discussion of health risks focus on issues related to distracted driving, not secondhand smoke.

The BMA report describes the tobacco industry’s position like this: “The proposal to ban smoking in what is a private space is a step too far and an unwarranted intrusion on individual freedeom.” To that, the doctors retort: “It is important to note, however, that this takes no account of the freedom of other individuals to use the roads safely, and for other individuals to be free from the risks posed by distracted drivers.”

The Greenbelt secondhand smoke trial came to a quick conclusion today after a lengthy trial. Judge Albert Northrop ruled David Schuman deserved no compensation for his claim that his neighbor’s secondhand smoke created a nuisance that Greenbelt Homes Inc. (GHI) failed to solve. Northrop noted if he had ruled in favor of Schuman the case would set the precedent for action on secondhand smoke claims not just for condominiums and townhomes, but also single-family homes.

Instead, Northrop said that the level of secondhand smoke entering David Schuman’s townhouse was not an actionable nuisance. Nor did he see bad faith in GHI’s handling of Schuman’s complaints.

After the decision was read, David Schuman and his attorney, J. P. Szymkowicz walked out of the courtroom and retreated to a conference room.

“We’re very pleased with the outcome,” said Gretchen Overdurff, GHI general manager, after the decision was read, “It was appropriate and our counsel did a good job.”

Defense Argues on Behalf of GHI

GHI lawyer Jason Fisher broke down the facts during his closing arguments.

He said the plaintiff had not proven any monetary damages as a result of the secondhand smoke.

“Where’s the basis to award one cent?” he asked, and turned to the plaintiff, “You have no evidence submitted whatsoever to give a dollar figure.”

Fisher pointed out that members living in GHI—an historic community of about 1,600 closely situated townhouses—have to deal with small inconveniences on a daily basis.

He also noted that the GHI members that testified said they had smelled, heard or experienced something in GHI that they may not have liked, but tolerated.

Arguing that GHI acted amicably in the complaints, Fisher referenced the hearing GHI gave Schuman and talked about how GHI offered to reseal his unit a second time.

He then said there was a significant possibility that Schuman’s own renovations in late 2008 caused the smoke problem to come back.

In court, Fisher displayed a giant poster board before the courtroom containing a diagram of Schuman’s townhouse. He had highlighted the regions where Schuman’s renovations were done and then laid red circles over areas where Schuman had claimed that he smelled smoke. The red and yellow overlapped.

During the preliminary injunction hearings, Judge Northrop had said it was not appropriate to consider the renovations as the cause of the smoke.

During his ruling, he said, “he didn’t have all the details” previously, after hearing closing arguments, however, he said he couldn’t rule out the renovations as a cause.

Fisher said the “smoking gun” in the case was when James Repace, the biophysicist hired by the plaintiff found the same level of cancer-causing particles with his monitor in the smoke-free courtroom as he had in Schuman’s living room while Darko Popovic was smoking outside.

“Shouldn’t that create a cause of action for everybody in here?” he asked.

Repace said after the trial that Fisher’s argument was bogus and showed a lack of understanding.

The Plaintiff’s Side Rests its Case

The lawyers for the plaintiff rested their case on the arguments presented in a 156-page brief filed with the court about a week before closing arguments.

During his closing argument, Schuman’s attorney J.P. Szymkowicz recalled the testimony of the defense’s expert witness Dr. Ronald Gots. He said Gots said the levels of secondhand smoke suffered by Schuman might cause a medical problem in 2 out of 10,000 people.

“What would it be like to be one of those two people?” asked Szymkowicz.

Judge Northrop Explains His Ruling

After closing arguments, Judge Northrop told his own story. He said he grew up in a home where his dad had smoked regularly. He added that he was asthmatic as a child growing up and that his sister died in 2001 of lung cancer, caused by smoking.

Northrop said in Maryland smoking has already been banned in restaurants and courthouses. Legislatures have looked at it and chosen not to ban it generally. It’s a decision that’s going to have to be made by the legislature, he said.

“There needs to be actionable harm,” said Northrop, “I can’t find there’s an actionable nuisance in this case.”

Northrop found in favor of the defendant on eight of the nine counts, but he granted a permanent injunction against inside smoking by Mr. and Mrs. Popovic.

The Popovics are still able to smoke outside. Darko noted to the court that his wife has already quit smoking due to a brain tumor, unrelated to her smoking, and that he currently only smokes outside.

Schuman Says He Has to Move

After about 15 minutes huddled inside a conference room after Northrop’s decision, David Schuman emerged and said he was very disappointed in the outcome of the case.

“I’m going to have to move,” Schuman said, “If I can sell the house.”

He said the likelihood of others bringing another case like this one to court will be very difficult if not impossible. For his part, he said he would have to evaluate whether to appeal.

More Cases to Come

Gathered in the courtroom on Thursday were at least two other people that had similar cases to Schuman’s.

One said that she too suffered from secondhand smoke problems in her home. She said J.P. Szymkowicz was her attorney. Another complained in the hallway to Szymkowicz’ mother about her problems with secondhand smoke.

James Repace said he had signed up two new clients to test for secondhand smoke in their home since the trial began.

Before leaving the courthouse, Jason Fisher, attorney for GHI, discussed secondhand smoke cases and declared, “I think you’ll see more cases like this, and they’re going to get better at it each time.”

Hearing loss has been linked to second hand smoke and alcoholic beverages, but this doesn’t stop young adults and even teengers from breathing secondary smoke. And for older students, alcoholic beverage use may damage hearing. On top of that add loud music and earphones that play for hours. It adds up to significant hearing loss, even deafness later in life. Since both alcoholic consumption and second hand smoke may damage hearing, you can only imagine what the ears have to endure while listening for hours to music played loud with earphones.

Does tobacco use as a teenager lead to deafness later in life? Teenagers who start using tobacco early in life may soon loose their hearing ability. Some may go deaf. And any other people breathing secondary smoke from those smoking teenagers can also develop significant hearing loss.
Tobacco companies in California should warn young people that smoking may not only lead to lung cancer but also to deafness. Smoking may also go along with loud music. Combined with secondary smoke, teenagers often lose their hearing early in life. And adults or teenagers who also drink beer and breathe second hand smoke from a closed environment like a night club or just breathe smoke from older relatives in their parent’s home also may lose their hearing. In fact, adults or people of any age can damage their hearing just from sipping beer. See, Alcohol Consumption Can Damage Hearing.
See the article in Hearing Health Magazine. Sipping alcohol damages the brain stem which in turn helps to cause the hearing loss. On top of that, breathing tobacco smoke or even second hand smoke from others, damages hearing even more. And still more damage to the hearing is done by wearing ear phones for hours or listening to loud music.

“Smoke exposure causes significant damage and lasting consequences in newborns,” Pinkerton said in the UC Davis news article. “This research has a message for every parent: Do not smoke or breathe secondhand smoke while you are pregnant. Do not let your children breathe secondhand smoke after they are born.”
Pinkerton added that the results from this study are further proof that secondhand smoke’s effects on children are not minor, temporary or reversible. “This is the missed message about secondhand smoke and children,” he said. “Parents need to understand that these effects will not go away. If children do not grow healthy lungs when they are supposed to, they will likely never recover. The process is not forgiving and the children are not going to be able to make up this loss later in life.”
The UC Davis research is reported in the Aug. 15, 2006 issue of the American Journal of Respiratory and Critical Care Medicine. That study was done with rhesus macaque monkeys, in order to obtain the best possible understanding of what happens in people. Pregnant macaques were exposed to smoke levels equal to those that a pregnant woman would breathe if someone in her home or workplace smoked. Newborn macaques were exposed to secondhand smoke levels similar to those a human baby would breathe if it was cared for by a moderate-to-heavy smoker.
What the researchers found is that environmental tobacco smoke wreaks havoc in babies at a critical time in the development of lungs — when millions of tiny cells called alveoli (pronounced al-VEE-o-lye) are being formed. Alveoli are the place where oxygen passes from the lungs into the bloodstream. Human infants are born with only about one-fifth of the 300 million alveoli they will need as adults. They construct almost all those 300 million alveoli between birth and age 8.
In the 2006 study, the researchers analyzed step-by-step how the alveolar cells’ inner workings reacted to cigarette smoke. They found the normal orderly process of cell housecleaning had gone haywire. In healthy people, cells live and die on a schedule. Programmed cell death, called apoptosis (a-pop-TOE-sis), is regulated by genes that increase or decrease various chemical reactions in the cell, the UC Davis article reported.
Funding for the study, “Environmental Tobacco Smoke Suppresses Nuclear Factor Kappa B Signaling to Increase Apoptosis in Infant Monkey Lungs,” was included in a five-year, $1.5 million research grant from the National Institute of Environmental Health Sciences and $450,000 from taxes on sales of tobacco products in California.

Air cleaners significantly reduce particulate matter (PM) levels but are not enough to reduce exposure to secondhand smoke in inner-city children with asthma residing with a smoker, a new study has found. Arlene M. Butz, ScD, MSN, CPNP, with the Division of General Pediatrics at The Johns Hopkins University School of Medicine, in Baltimore, Maryland, and colleagues reported the findings in the August issue of the Archives of Pediatrics & Adolescent Medicine.

“Despite parental awareness that second-hand smoke exacerbates asthma, 40% to 67% of inner-city children with asthma reside in a household with at least 1 smoker,” the study authors note. According to the researchers, PM concentrations of secondhand smoke exposures have previously been found to be reduced with the use of air cleaners.

The current study sought to test the ability of an air cleaner only (n = 41), an air cleaner plus a health coach (n = 41), or delayed air cleaners (control; n = 44) in reducing PM, air nicotine, and urine cotinine concentrations. The number of symptom-free days was also evaluated.

Eligible children were aged 6 to 12 years, with clinician-diagnosed asthma, symptom frequency, and/or controller medication use signifying persistent asthma. A smoker, who smoked more than 5 cigarettes per day and resided in the home at least 4 days per week, was also present.

Reductions in mean fine and coarse PM (PM2.5 and PM2.5-10) concentrations from baseline to 6 months were significantly higher in both air cleaner groups vs the control group (PM2.5 concentrations, P = .003; and PM2.5-10 concentrations, P = .02 for differences between both air cleaner groups and control).

However, the presence of secondhand smoke, as measured by air nicotine and urine cotinine concentrations, was comparable among the groups. Use of a health coach did not further reduce PM concentrations.

Air cleaner groups, when combined, had a significant increase in symptom-free days during the past 2 weeks (1.36 vs 0.24 symptom-free days for control group children from baseline to follow-up), representing an increase of 14% to 18% symptom-free days, and yielding an additional 33 symptom-free days per year.

“Use of air cleaners in homes of children with asthma was associated with a significant reduction in indoor PM concentrations and increase in symptom-free days,” the study authors note. “However, the reduced indoor PM levels were not sufficiently decreased to meet EPA [Environmental Protection Agency] standards for outdoor air quality,” they add.

Despite years of graphic anti-smoking campaigns and public smoking bans, people continue to light up — especially at home, where more than half of American children and teenagers are exposed to secondhand smoke. Scientists believe that passive smoke either causes or exacerbates lung cancer, asthma, learning disabilities, heart disease and other conditions and now a new study now finds that teenagers exposed to tobacco smoke may also have significant hearing loss — and not even know it. Here, a brief guide:

How was this study conducted?
Researchers from the New York University School of Medicine tested over 1,500 adolescents aged 12 to 19 for blood levels of cotinine, a byproduct of nicotine that forms when people are exposed to tobacco smoke. They also tested the teens’ ability to hear high-, medium- and low-frequency sounds.

What did the researchers find?
Teenagers who’ve been exposed to secondhand smoke have roughly double the risk of hearing loss compared to those with little or no exposure. And the more these teens have been exposed to tobacco smoke, as measured by their blood levels of cotinine, the greater their risk of significant hearing loss. Teenagers with the highest levels of exposure had nearly triple the risk of hearing loss.

How bad is their hearing?
They weren’t deaf, but their hearing was measurably impaired. And a startling number of these teens — over 80 percent — had no idea that they had significant hearing loss. “It’s kind of surprising,” says Dr. Joseph DiFranza, as quoted by Reuters Health. “We already knew that passive smoking is bad for children,” but “this just piles on another reason” to keep tobacco smoke away from kids.

How does hearing loss affect teens?
Hearing impairment was especially noticeable in the mid- to high-frequency range, which means the adolescents might have difficulty understanding human speech. That could result in problems at school, where they may be singled out as troublemakers, fail at social interactions, or be misdiagnosed with ADHD or other behavioral problems.

What can parents and teachers do?
The obvious first step is to minimize children’s and teen’s exposure to tobacco smoke. Testing is another important step: Infants are regularly screened for hearing loss, but there are no guidelines for hearing tests past the early school years. One researcher noted that all children and teenagers exposed to secondhand smoke should be regularly screened for hearing loss, in case hearing aids are warranted.

WALES could be the first European country to ban smoking in cars carrying children, First Minister Carwyn Jones announced yesterday. Mr Jones said legislation could be considered if children’s exposure to second-hand smoke did not reduce as a result of a campaign. A ban would be designed first and foremost to protect children from second-hand smoke as well as encouraging adults to give up smoking, he said.

The First Minister said that it would be the next logical step following the ban on smoking in offices, pubs and restaurants.

He said: “Wales was the first UK country to vote in favour of a ban on smoking in public places and if necessary we will not shy away from considering the introduction of progressive legislation to further protect children from second-hand smoke.”

It was not entirely clear how any such move would be policed. Mr Jones told the Western Mail that no new road traffic offence would be created, although he suggested there was “plenty of scope for joint working” with the police.

Legislation will not be considered until the end of a three- year campaign warning drivers about the dangers to children in the car of lighting up while driving.

Mr Jones said: “Children are particularly at risk from second-hand smoke, especially in vehicles where a confined space means there is no respite from the harm of the toxic chemicals in cigarettes.

“Our manifesto committed us to take tough action to tackle inequalities in health, particularly the harm caused by tobacco use and its effect on children.

“The law already requires any vehicle that is used by more than one person in the course of paid or voluntary work to be smoke free and an extension is the next logical step.

“We will mount a renewed campaign to tackle smoking alongside other interventions such as quit programmes, but will consider pursuing legislative options if children’s exposure to second-hand smoke does not start to fall within the next three years.

“There is a growing public consensus on the social unacceptability of being exposed to second-hand smoke and introducing legislation would be a powerful statement of intent about our commitment to the health of our children,” he added.

Chief Medical Officer for Wales Dr Tony Jewell said: “Children are particularly vulnerable to the effects of smoking, and with no escape from second-hand smoke are more likely to develop long- term conditions such as asthma at an early age, which will affect them for their rest of their lives.”

The move from the Welsh Government comes less than two weeks after the British Medical Association called for drivers to be prevented from lighting up in their vehicles.

In June the BMA’s conference in Cardiff passed a motion calling for legislation to be introduced by all governments in the UK to tackle the issue of smoking while driving, to protect the health of other passengers and to increase the safety of other road users.

Delegates heard that smoking in a car was more damaging to a person’s health than breathing in exhaust fumes, because particle concentrations were 27 times higher than in a smoker’s home and 20 times higher than they used to be in a pub, when smoking was allowed.

That made it safer to have the exhaust pipe on the inside of the car than to smoke cigarettes in terms of fine particulate matter.

Research by the British Lung Foundation found that more than a third of children with a parent who smoked said the parent smoked in the car while the child is a passenger.

A teenager on a Port St. Lucie community baseball team says second-hand smoke was striking out with his teammates, so he took his complaint all the way to the City Council. Marcus Rigg is a recent graduate from Treasure Coast High School. The 17-year-old said he and his teammates were distracted by smoke coming from the bleachers while playing baseball for the Whispering Pines Park youth league.

Rigg took a swing and headed to the City Council determined to make a change.
“So we got a petition together, got about 300 signatures, and took it to City Council,” Rigg said. “I actually presented my petition in front of City Council, which was unexpected.”
The City Council voted Monday in favor of a policy that regulates where smoking is allowed at city parks.
I think it’s great,” Madeline Medina said. “My son is catcher, and I can’t deal with the people smoking in back of the dugout and everything.”
Rigg said he was told that he wouldn’t be able to make a difference because he’s just a kid.
Port St. Lucie’s communications director said the parks department is implementing designated smoking areas and will soon post signs at all city parks.

Most smokers are very aware of the damage they are doing to their own health – and know that others can also suffer though passive smoking. But a worrying new study reveals that smoking infront of children not only passes on the harmful effects of the smoke in the air – it can also get them hooked on cigarettes. A Concordia and University of Montreal study published in the Oxford journal Nicotine & Tobacco Research, found that tweens who repeatedly observe a parent, sibling, friend or neighbur consuming cigarettes are more likely to start smoking themselves.

‘Kids who see others smoking are more likely to take up the habit because they don’t perceive cigarettes as unhealthy,’ says lead study author Simon Racicot, of Concordia University’s Department of Psychology.
‘We found that kids who’d never smoked who were exposed to tobacco use were more likely to hold positive beliefs about the killer habit. These are the kids who are more likely to start smoking as teenagers.’
This new investigation builds on previous studies examining the negative effects of being surrounded by smokers.
Senior author Jennifer J. McGrath, a professor in the Concordia University Department of Psychology said around 60 per cent of children are exposed to secondhand smoke across North America.
‘Greater exposure to smokers is largely associated with greater exposure to nicotine,’ she said.
‘Children exposed to the same amounts of secondhand smoke as adults absorb higher doses of nicotine.
‘Early findings suggest that secondhand smoke exposure could possibly trigger addiction in the brain – before kids actually start smoking themselves.’
For the study, 327 11-13 year olds enrolled in French-language public schools were questioned about their smoking habits, the number of smokers in their entourage and the situations where they observed smoking.
‘Preteens who were surrounded by more smokers believed that there are greater advantages to smoking,’ says Racicot.
‘Therefore, smoking by parents, siblings, and friends increases risk factors for later smoking.’
The researchers argue that new prevention efforts must be tailored to children who are highly exposed to secondhand smoke – ensuring they are aware of the risks.
The general public also needs to be informed about how smoking around youth normalizes the dangerous habit.
‘When it comes to smoking around kids, the best thing a parent can do is to avoid exposing their kids to cigarettes and to secondhand smoke,’ says Racicot.
‘A parent should step outside of their home or car to smoke. And the addictive habit should remain out of sight, out of breath and out of mind.’

Moderate secondhand smoke exposure results in occupancy of brain α4 β2 nicotinic acetylcholine receptors (nAChRs), which may increase vulnerability to smoking and nicotine addiction, new research shows. Study investigators found that after 1 hour of exposure to secondhand smoke in an enclosed space, a substantial amount of nicotine reaches the brains of nonsmokers and binds to receptors that are normally targeted by direct exposure to tobacco smoke — a finding that has important implications.

“We know that secondhand smoke exposure results in exposed individuals being more likely to become smokers and to have a harder time quitting smoking [if they are already smokers],” first author Arthur L. Brody, MD, from the Greater Los Angeles Veterans Affairs Healthcare System and the University of California, Los Angeles, told Medscape Medical News.

“Our study presents further evidence for the need to limit exposure to secondhand smoke in vulnerable individuals,” he added.

The study was published online May 2 in the Archives of General Psychiatry.

Priming the Brain

In laboratory rats, long-term exposure to cigarette smoke leads to nicotine dependence and an upregulation of nAChR levels in the brain. Yet, “brain nAChR occupancy from secondhand smoke exposure has not yet (to our knowledge) been demonstrated,” the researchers write.

In the study, 11 moderately dependent cigarette smokers and 12 nonsmokers underwent positron emission tomography with the radioligand 2-(18)F-FA-85380, which permits visualization of brain α4 β2 nAChRs, one of the most abundant nAChR subtypes in the brain.

Each participant underwent 2 scanning sessions during which they sat in the passenger seat of a car for 1 hour and were exposed to moderate secondhand smoke or to no secondhand smoke.

During the smoke exposure condition, the mean air carbon monoxide level was 7.4 parts per million (ppm) — significantly higher (P < .001) than during the control condition (0.5 ppm).

For the entire group (smokers and nonsmokers), moderate secondhand smoke exposure led to an average 19% brain α4 β2 nAChR occupancy, the researchers say.

Evidence Supports Public Smoking Ban

“These results show that even limited secondhand smoke exposure delivers enough nicotine to the brain to alter its function,” Nora D. Volkow, MD, director of the National Institute on Drug Abuse, who was not involved in the study, noted in a statement.

“Chronic or severe exposure could result in even higher brain nicotine levels, which may explain why secondhand smoke exposure increases vulnerability to nicotine addiction,” Dr. Volkow added.

The researchers also found that smokers had a 23% increase, on average, in craving with secondhand smoke exposure, and they saw a correlation between nAChR occupancy and craving alleviation with subsequent cigarette smoking. This finding suggests that moderate secondhand smoke exposure delivers a priming dose of nicotine to the brain that contributes to continued cigarette use in smokers, they say.

“This study,” Dr. Brody said, “gives concrete evidence to support policies that ban smoking in public places, particularly enclosed spaces and around children.”