The World Health Organization (WHO) signalled the urgent need for countries to make all indoor public places and workplaces 100% smoke-free with the release of its new policy recommendations on protection from exposure to second-hand tobacco smoke in advance of World No Tobacco Day (31 May), which focuses this year on this theme.
"The evidence is clear, there is no safe level of exposure to second-hand tobacco smoke," said the WHO Director-General Dr Margaret Chan. "Many countries have already taken action. I urge all countries that have not yet done so to take this immediate and important step to protect the health of all by passing laws requiring all indoor workplaces and public places to be 100% smoke-free."
There are about 4000 known chemicals in tobacco smoke; more than 50 of them are known to cause cancer. Exposure to second-hand smoke causes heart disease and many serious respiratory and cardiovascular diseases that can lead to premature death in adults. It also causes diseases and worsens existing conditions, such as asthma, in children. The new WHO policy recommendations are based on the evidence of three recent major reports, which all reached the same conclusion: Monograph 83 Tobacco Smoke and Involuntary Smoking by the International Agency for Research on Cancer (IARC), the United States Surgeon General's Report on The Health Consequences of Involuntary Exposure to Tobacco Smoke and the California Environmental Protection Agency's Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant.
Exposure to second-hand smoke occurs anywhere smoking is permitted: homes, workplaces and other public places. An estimated 200 000 workers die each year due to exposure to smoke at work. WHO estimates that around 700 million children, or almost half of the world's children, breathe air polluted by tobacco smoke, particularly at home.
The Global Youth Tobacco Survey, developed by WHO and the United States Centers for Disease Control and Prevention (CDC), interviewed students between 13 and 15 years old in 132 countries between 1999 and 2005. The results of the survey show that 43.9% of the students are exposed to second-hand tobacco smoke at home, while 55.8% are exposed to smoke in public places. Support for smoking bans in public places is global, with 76.1% of the students surveyed in favour.
The costs of second-hand smoke are not limited to the burden of disease. Exposure also imposes economic costs on individuals, businesses and society as a whole. These include primarily direct and indirect medical costs, but also productivity losses. In addition, workplaces where smoking is permitted incur higher renovation and cleaning costs, and increased risk of fire, and may experience higher insurance premiums.