Did Carmona Read His Own Report?

Michael Siegel, a tobacco control activist who supports government-imposed smoking bans, slams the Office of the Surgeon General for falsely claiming or implying that brief, transient exposure to secondhand smoke raises the risk of lung cancer, cardiovascular disease, and heart attack. The inaccurate or misleading statements appear not in the surgeon general's report on secondhand smoke but in the press release, fact sheet, and remarks by Surgeon General Richard Carmona that accompanied the report's publication. The press release, for example, claims that "even brief exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and increases risk for heart disease and lung cancer," attributing this finding to the report. Siegel, who believes that long-term, intense exposure to secondhand smoke (such as that experienced by people married to smokers for decades) can cause lung cancer and heart disease, faults the surgeon general for "distort[ing] the science in an effort to sensationalize it and increase the emotional impact of the communication":

There is absolutely no evidence to support this claim. Certainly, no evidence is presented in the Surgeon General's report to support this claim. And certainly, the Surgeon General's report draws no such conclusion.

In fact, such a conclusion flies in the face of common medical sense. How could it possibly be that a brief exposure to secondhand smoke can cause heart disease? It takes many years for heart disease to develop. It takes years of exposure to tobacco smoke even for a smoker to develop heart disease. I estimate that it takes at least 25 years of exposure (based on the fact that very few smokers are diagnosed with heart disease before age 40).

So how could it possibly be that for an active smoker, heart disease takes 25 years of exposure to tobacco smoke to develop, but for a passive smoker, it only takes a single, transient, brief exposure?

It is also quite misleading to tell the public that a brief exposure to secondhand smoke increases the risk of lung cancer. There is certainly no evidence for this and the Surgeon General's report itself draws no such conclusion. In fact, the report makes it clear that most of the studies linking secondhand smoke and lung cancer studied nonsmokers with many years of intense exposure.

In his remarks, Carmona similarly claimed that "breathing secondhand smoke for even a short time can damage cells and set the cancer process in motion. Brief exposure can have immediate harmful effects on blood and blood vessels, potentially increasing the risk of a heart attack." Clearly, it's not just the news media that are misrepresenting the findings of the surgeon general's report. So is the surgeon general.