Surgeon General's report on involuntary smoking

The Health Consequences of Involuntary Smoking was prepared by the CDC's Office on Smoking and Health under Public Law 91-222, which required reports to Congress on new information about smoking and health. It dealt with the smoke nonsmokers breathe from other people's cigarettes. Sidestream smoke, released between puffs, was chemically similar to the mainstream smoke a smoker inhales, and both acted as carcinogens in laboratory bioassays. Measurements of smoke components in indoor air, and of nicotine absorbed by nonsmokers, pointed to exposures that would be expected to carry a lung cancer risk.

Of 13 epidemiological studies available, 11 found a positive relationship between exposure and lung cancer in nonsmokers, and 6 of those were statistically significant. The report drew three conclusions. Involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers. Children whose parents smoke have more respiratory symptoms and infections and slightly slower growth in lung function. Separating smokers and nonsmokers within the same air space may reduce exposure but does not eliminate it.

The report also traced the spread of smoking restrictions: institutions began adopting them in the 1970s, local ordinances had multiplied since 1980, and polls showed growing support for limits in public places. In his preface Surgeon General C. Everett Koop wrote that smoking was an addictive behavior and the smoker's own choice, but that the choice could not override nonsmokers' right to air free of tobacco smoke.

An accompanying CDC note cited a National Academy of Sciences estimate that about 20 percent of the roughly 12,200 lung cancer deaths a year among US nonsmokers were due to environmental tobacco smoke. The National Library of Medicine's profile of Koop says the report presented secondhand smoke as a quantifiable health risk, especially to children, and that his campaign gave the anti-smoking movement the scientific base it later used to win bans on smoking in federal buildings and on public conveyances nationwide.