European Stars and Stripes (Newspaper) - December 11, 1990, Darmstadt, Hesse                                Ycoy Exir health by Nicole Wise new York time studies probe passive smoking link to health problems m any health conscious americans have stopped smoking in Light of the evidence jinking tobacco Smoko to lung cancer and heart disease but close to one third of the adult population in the United states is still. Addicted to cigarette smoking. The american cancer society predicts that in 1990, 157,000 now cases of lung cancer will be diagnosed and 142,000 americans Wili die of he disease. A recent study published in the new England journal of Medicine found that children who grow up in a. Household with heavy smokers have twice As great a risk of getting lung cancer. The study a principal author or. Dwight t. Jane Rich a professor of epidemiology at the Yale school of a Medicine said it also enumerated findings regarding a a a a adults and second hand smoke. V in a recent conversation at his office at Yale Janerich talked about his studies and More generally about the harmful effects of inhaling environmental tobacco smoke., v Herd Are some excerpts from the conversation Why is it that children seem to be especially vulnerable to the Iii effects of second hand cigarette smoke. As Early As 1978, Richard doll who is perhaps the most eminent researcher in the area of tobacco. Smoking and epidemiology raised a question about the potential risk to children who Are heavily exposed to second hand cigarette smoking Early in  we Arentt the first to recognize that there might be a problem. We Are however the first to have any Strong data that Points in that direction so i think we ought to. Wait for confirmation. A a. A a / now with regard to other findings of other investigators about chronic and acute respiratory problems and other health issues where children a. Appear to be More susceptible the evidence is pretty v Strong and seems to suggest that the immature lung is More susceptible to the irritation provided by second hand smoking a a a a a a whether that same set of findings is related to the Long term effects that produced cancer we Are not a quite sure at this time. J. How much of a risk does occasional exposure o second hand smoke hold for healthy adults basically our findings indicate that As a child and adolescent you need to be exposed fairly regularly inthe household to other people s smoking in order to. Double the risk of cancer. So if we re talking about someone who is not living in a House with a smoker and is occasionally in a restaurant Astorfi Cibie or some other social setting where there is a passing exposure to cigarette smoke once a week or once a month i would guess that it is reasonable to conclude that there is not a great Deal of risk. Ai \ however that a not proven. Its just extrapolation from the existing data a a what were your findings about spouses of heavy smokers our findings did t show an increased risk. The first epidemiological findings that indicated an Adverse cancer effect focused on the spouse As the source of smoking and they came from Greece and Japan i Don t know much about the social Selling in Greece regarding House size , but  a Little a bit about Japan from some very minimal travel there. In Japan families tend to live together in a relatively Small space especially the lower socioeconomic. Classes. A a so it is conceivable that the amount of cigarette a. Smoke that accumulates from just the spouse s. A. Smoking would be enough to generate a sufficiently a Quot Large reaction to generate cancer in the United states where the housing conditions Are somewhat different and where the temperatures  Are different we did t find exactly the same result. That does t mean the other studies Aren t Correct because those were done under environmental conditions that were very specific and probably different a from ours. ,. A i believe we Are going to have to look to engineers and environmentalists to give us a better idea about How much of the dose occurs Given a certain amount of. Smoking before redraw the final conclusions on that Issue. \. A a a a. A How Long does lung cancer typically take to develop. A a. I Don t think anyone knows that for certain. We know that in Many of the common cancers such As breast cancer there is evidence of a very very Long latency. Our evidence is among the first to prove a very Early. Life exposure increasing the risk and i would say that Evi Jence Oil Early life exposure to anyone of a number of carcinogenic factors Are gradually being shown to cause adult cancer that a not a very direct answer to your question but i think a direct answer is not easily had. A a -. Are there environmental considerations that have an Impact on the degree of exposure to second hand smoke it s not easy to quantify this. The average lung cancer patient in our study was born in the 1920s, and we had to look Back and imagine hot the Way it is today but the Way it was then for a child who May have grown up living with an extended family during the depression in order to really visualize the situation i could Only do that in a sort of limited Way because i did t live  i believe in order to put these kinds of things in perspective environmentalists and engineers Are going to have to Teli us Given a certain volume in a room and a certain insulation value and a certain heating component this much smoking translates into this much exposure. A that kind of detail is not readily available to us at this Point but i Belleve that organizations like the environmental Protection Agency and the National Institute of environmental health sciences will be in future years  these kinds of issues so that we can begin to get factors that will help us to. Understand what these relatively crude measures that a we be been using like smoker years and pack years really mean. A Gan you Quantity How much passive smoking can Lead to health problems ? a we have quantified it in our study and t think we be come one step closer than previous studies in terms of measuring the number of smokers in a household the a Page 16. A a a the stars and stripes tue s Day d Ece be r 11,199 0. Number of years of exposure and the period of life in a which they be lived. A but any time a study is completed and the results Are presented a Good scientist is going to realize that there is a better step that can be taken. A this crude estimate of ours 25 smoker years of. Exposure leading  doubling of the lung cancer rate. When that exposure occurs in carry childhood and. Adolescence is just that relatively crude. I would think a that 10 or 15  now or even sooner we will a have a lot better measure than we have today a what Are some of the other health problems related to second hand smoke exposure it certainly appears that the usual respiratory problems with children Are made worse by being around environmental tobacco smoke. A and i think that the problems of cardiovascular disease and cardiopulmonary stress related to environmental tobacco smoke have been discussed by a number of investigators v. Those two represent perhaps the most important of the features that i think people need to be concerned about. And the surgeon general a 1986 report reviews Ina Broderway the health problems associated with the environmental tobacco smoke. I think it gave an excellent summary of what the health effects Are and it is basically an indicting set of findings. Can you summarize the other risk factors for lung cancer beyond cigarette smoking the one that is getting the most play lately is genetics and we Are very interested in that and certainly will be paying More attention to it in our studies there has been a historical notion held by some. People that genetics is. Environmental factors Are either or and i think that evidence is growing that it is a combination of both. A a genetic susceptibility in the presence of environmental risk factors Only makes a situation worse. Why has your study been viewed As  think that the controversial aspect of it is one that the tobacco companies have focused on particularly and that is that our findings on social smoking show a reverse trend and our findings on occupational. Smoking show basically nothing a but you have to remember we had nothing but the crudest kind of measurements and i believe the social and occupational measures were the least sure of All. A work space and social setting exposure Arentt As. Easily measured As the household where there is not that wide a Range even from the biggest to smallest space. Our findings were interpreted by the tobacco companies As being reassuring but i think that anyone. Who becomes reassured by the data is whistling past the graveyard so to speak. Do you have any advice for individuals who were raised in the Homes of heavy smokers ? certainly to avoid any further exposure As Best they can. But i certainly  recommend that they get a fatalistic View of this because cancer no matter How. Scary a word is still not a very common disease even Fung  you have a relative risk of two fold among nonsmokers it. Means that you take a fairly rare event and make it a Little less rare by this risk Factor but it is not something that should dominate the lives of people. I think it is More important in terms of Public policy a. Than it sin terms of what it Means for any  do you do when someone lights up in a social setting i Don to like socially aggressive behaviour but have on Many occasions asked people not to smoke. A a when i go into a restaurant if people Are smoking a a heavily i will either leave the restaurant or find a place where Mere is no exposure. And in our Home we a Taven t allowed people  for Many Many years. R