Each year up to 65,000 adult non-smokers die from heart disease and 3,000 more succumb to lung cancer because of passive smoking in the United States.

And it is no wonder, because in just half-an-hour the chemicals in cigarette smoke affects a passive smoker, according to Ms Claudine Oh, a pharmacist and smoking cessation counsellor at Alexandra Hospital. She explained that passive smokers inhale the same harmful chemicals that active smokers do. "Studies have conclusively indicated that when non-smokers inhale tobacco smoke, they are more likely to contract bronchitis, pneumonia and diseases related to the heart and blood vessels," she said. So, even though passive smokers may not be inhaling as many chemicals as active smokers do, the overall impact on their health is significant. "After just half-an-hour of being exposed to passive smoke, chemicals in the smoke change the characteristics of blood vessels in non-smokers," Ms Oh said. The reason lies in the type of smoke, she said. Generally, smoke can be classified into either mainstream or sidestream smoke. Sidestream smoke, which comes from the burning tip of a cigarette, affects the passive smoker. Compared to mainstream smoke, which is smoke that has been inhaled and exhaled by a smoker, sidestream smoke contains greater amounts of ammonia, benzene, carbon monoxide, nicotine and some cancer-causing agents from the same amount of burnt tobacco. "However, because sidestream smoke is often mixed with air before being inhaled, the concentration of toxic chemicals inhaled by passive smokers is not the same as that inhaled by active smokers," she said. "In addition, sidestream smoke particles tend to be smaller than those of mainstream smoke, allowing it to be inhaled more deeply into the lungs," she said. Of concern, though, is how it is relatively easy for just about anyone to be susceptible to sidestream smoke, be it at home, in the office or in open, public spaces. In Singapore, 15 per cent of the population are smokers. That leaves a large pool of potential passive smokers. According to Dr Loo Chian Min, a consultant with the department of respiratory and critical care medicine at the Singapore General Hospital, children and the elderly are more sensitive to the effects of passive smoking due to weaker immune systems. Tobacco smoke also causes additional problems for growing children and asthmatics, he cautioned. Experts say that the effects of tobacco smoke on pregnant women is similar to that of active and passive smokers. Said Dr Loo: "For women, this includes a reduction in the ability to conceive by up to 40 per cent per cycle. Men are twice as likely to have damaged DNA in their sperm. Even when conception is successful, tobacco smoke inhalation could cause bleeding during pregnancy and spontaneous abortions." While legislation such as banning smoking in air-conditioned places and bus terminals have been put in place to protect non-smokers, the onus still lies with the individual to prevent coming into contact with sidestream smoke. But when someone in the family or a co-worker smokes, it becomes more of a challenge to stay away. Advised Dr Loo: "Family members and friends of smokers should make the continuous effort to encourage smokers in their lives to go through the hard but fulfilling quit process. "Employers can institute in-house smoking bans and supportive programmes for employees. Healthcare professionals also play a key role in encouraging smokers to quit by offering appropriate advice, especially in relation to the patients' health conditions." The chairman and chief executive officer of the Raffles Medical Group, Dr Loo Choon Yong, agreed. "A smoke-free workplace promotes better health and well being. It also enhances productivity and reduces smoking-related illnesses and absenteeism," he said. "When we launch a well-planned and carefully implemented effort to stem smoking at the workplace, we are telling our employees that we care about their health and safety, as well as the health and safety of their families. "My driver quit smoking after joining our company. He is a healthier and fitter man today." For those who need help to quit smoking, call the Health Promotion Board's QuitLine at 1800 438 2000 or Alexandra Hospital Pharmacy to enquire about their smoking cessation clinics at 6379 3320. - TODAY/jt

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