Secondhand smoke increases heart disease, heart attack and other health risks
In 2006, the U.S. Surgeon General issued a report concluding that there is no risk-free level of exposure to secondhand smoke. The finding is of major public health concern due to the fact that nearly half of all nonsmoking Americans are still regularly exposed to secondhand smoke.

While the Surgeon General’s report looked at secondhand smoke and heart disease in general, the Institute of Medicine’s October 2009 report links exposure to secondhand smoke to acute cardiovascular events such as heart attack and unstable angina.

The IOM reviewed 11 key studies on the relationship between smoking bans and heart attack -- 2 of which evaluated specifically the relationship between secondhand smoke exposure and heart attacks.  The IOM concluded that “there is a causal relationship between smoking bans and decreases in acute coronary events” – that is, that smoking bans translate into fewer heart attacks.

The IOM report did not estimate the amount of exposure that would likely cause a heart attack.  It also did not pin down how much of a decrease in heart attacks might be expected from smoking bans.  The 11 studies reviewed for the report showed decreases from 6 percent to 47 percent , but all used different forms of analysis and different contexts that could not be combined to a single number.

What we’re doing to help
The American Heart Association advocates strongly for comprehensive smoke-free workplace laws across the United States that are in compliance with the Fundamentals of Smoke-free Workplace Laws guidelines. 

The AHA believes that:

• smoke-free laws should apply to all workplaces and public environments
• there should be no preemption of local ordinances
• there should be no opting out
• there should be no exemptions for hardship or ventilation
• there should be no other exemptions such as for casinos and gaming organizations, bars, tobacco shops and private clubs.

Comprehensive smoke-free workplace laws help protect everyone, but especially groups that are already vulnerable to heart disease and stroke for other reasons. There is evidence that exposure to secondhand smoke affects minorities, women, and those in lower socioeconomic groups more than others, since many of these individuals work in the hospitality industry.  Blue collar workers are less likely than white collar indoor workers to be covered by smoke-free policies. 

As of October 2009, a total of 30 states, along with Puerto Rico and the District of Columbia, have laws in effect that require either 100% smoke-free workplaces and/or smoke-free restaurants and/or bars. More than 3,000 U.S. cities and towns also have local laws in effect that restrict where smoking is allowed. 

Despite this tremendous progress, it is estimated that 25-40% of the U.S. population is still exposed to cigarette smoke and its inherent risks, so there is still significant work to be done.

The American Heart Association will continue to advocate for smoke-free environments, to support healthy choices - including smoking cessation programs and anti-smoking campaigns - and to support research that seeks even more compelling evidence-based answers t still-unanswered questions.

Do your part to snuff out secondhand smoke

• If you smoke, we have resources to help you quit.
• If you live or work with smokers, support their efforts to quit. 
• Join You’re The Cureto be informed about and involved with our advocacy efforts.
• Check lists of smoke-free places at the Americans for Non-Smokers’ Rights Foundation Web site.  This link is provided for convenience only, and is not an endorsement or assurance of the entity or any product or service.

This content is reviewed regularly. Last updated 10/15/09.