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Home My WebLink AboutCOM 0732.019 2008-2010The American Heart Association mission is: Building healthier lives free of cardiovascular diseases and stroke.. Serving Hawaii since 1948 For information on the AHA's educational or research programs, contact your nearest AHA office, or visit our web site at www americanheart.orq. Honolulu County 667 Ala Moana Blvd., Suite.600 Honolulu, H1 96813 -5485 Phone: 808 -538 -7021 Fax 808 -538 -3443 Maul County: J. Walter Cameron Center 95 Mahalani Street, No. 13 Wailuku, HI 96793 -2598 Phone: 808- 244 -7185 Fax: 808- 242 -1857 Hawaii County: 400 Hualani Street, Ste 15 Hilo, HI 96720 -4344 Phone' 808- 961 -2825 Fax: 808- 961 -2827 Kauai County: (serviced by the Oahu office) Toll -Free 1 -866- 205 -3256 Testimony Supporting Bill 216 Please remember the American Heart Association in your will. American Heart American Stroke Association. Association. Ivan and Live.. Serving Hawaii The American Heart Association strongly supports Bill 216, "Relating to Prohibition of Smoking in Certain Places." The body of research on the dangers of smoking has long been acknowledged by health and science experts. However, in recent years, research focus has been extended to the dangers of being exposed to secondhand smoke and that growing body of research has been eye - opening to the point that many have shown that breathing secondhand smoke is not only deadly, but that it can be more dangerous than smoking. The California Environmental Protection Agency released in 2005 a report on the health effects of secondhand smoke based on a body of more than 1,000 research studies that went through four years of intense scientific, public and independent review. In the report, among other things, the report found a causal link between secondhand smoke exposure and pre -term delivery, asthma induction in adults (the link between asthma induction in children had already been well established), a 70 percent increase in risk for breast cancer in younger, primarily premenopausal women, and altered vascular properties. As a result of the report, California became the first state to declare seconhand smoke a toxic air pollutant. The decision by the California Air Resources Board put secondhand smoke in the same category as diesel exhaust, arsenic and benzene and blamed it for 4,000 deaths each year in California from lung cancer and heart disease alone. Also in 2005, a study done at the University of California at San Francisco (UCSF) found that non - smokers exposed to secondhand smoke are negatively affected in a much higher dose to response ratio than are smokers. Another UCSF study released in November 2006, showed that Philip Morris Tobacco Company had done extensive animal research on secondhand smoke at a secret laboratory in Germany and found it to be more toxic to non - smokers than inhaled cigarette smoke is to a smoker. The three -year review of Philip Morris documents made public by the multi -state settlement with the tobacco industry showed that the company did experiments on rats, which are less sensitive to smoke than humans. The documents show that Philip Morris scientists learned that secondhand smoke is chemically different than mainstream smoke inhaled by a smoker. The smoke drifting off the lit end of a cigarette releases larger, more poisonous molecules than those inhaled at the filter end. The heating that takes place in the process of smoking a cigarette helps to break down some toxins. Secondhand smoke was found to be three times more toxic to tissue culture cells than mainstream smoke. The effects of secondhand smoke on the cardiovascular system are substantial and immediate. Within 5 minutes of exposure to secondhand smoke blood platelets become stickier. Within 15 minutes of exposure, scarring of the blood vessel walls occurs causing plaque that leads to atherosclerosis to adhere more easily. Within 30 minutes of exposure, the risk for heart attack doubles. Carnrn. No. - 7 3 2 • 9 Ref. To; P Gil Ref. Date .- P � R if 1yay Please remember the American Heart Association in your will. American Heart I American Stroke Association. Association. Learn and Live.. Serving Hawaii In 2008, the CDC asked the Institute of Medicine to convene a committee to assess the relationship between secondhand -smoke exposure and effects on the heart. The committee evaluated three relationships: • The association between secondhand -smoke exposure and cardiovascular disease, especially coronary heart disease; • The association between secondhand -smoke exposure and acute coronary events (heart attacks); and • The association between smoking bans and heart attacks The IOM reviewed 11 key international studies and concluded that data consistently demonstrates that secondhand -smoke exposure increases the risk of coronary heart disease and heart attacks and that smoking bans reduce heart attacks. Given the prevalence of heart attacks, and the resultant deaths, smoking bans save more than half a million lives each year in the U.S. alone. The savings, as measured in human lives, is undeniable. Another study, published in the journal Environmental Health Perspectives in 2005 used the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 to 1994, to investigate the relationship between environmental tobacco smoke exposure and cognitive abilities among U.S. children and adolescents 6-16 years of age. The findings of that study confirmed previous research indicating an inverse relationship with ETS exposure and cognitive outcomes. The authors also provided new information indicating that ETS is neurotoxic at extremely low levels. Exposure to ETS in U.S. children therefore has substantial public health impact beyond asthma, otitis media, and other widely recognized adverse consequences. According to population estimates employing the appropriate sampling weights, they estimated that over 21.9 million American children are at risk for ETS - related reading deficits. Only recently a new danger related to tobacco smoke emissions began to emerge, a danger termed "third -hand smoke." A Lawrence Berkeley National Laboratory (Berkeley Lab) study published in February 2010 found that nicotine in third -hand smoke, the residue from tobacco smoke that clings to virtually all surfaces long after a cigarette has been extinguished, reacts with the common indoor air pollutant nitrous acid to produce dangerous carcinogens known as tobacco specific nitrosamines (TSNAs). Nitrous oxide is approved for use as a food additive, specifically as an aerosol spray propellant. Its most common uses in this context are in aerosol whipped cream canisters, cooking sprays, and as an inert gas used to displace oxygen, to inhibit bacterial growth, when filling packages of potato chips and other similar snack foods. Therefore, children exposed to nicotine in an automobile or home and then exposed to nitrous oxide can be exposed to TSNAs through either inhalation of dust or the contact of skin with carpet or clothes. The study's findings indicate that opening a window or deploying a fan to ventilate the room while a cigarette burns does not eliminate the hazard of third -hand smoke. Lara Gundel, co -author of that study was quoted; "Smoking outside is better than smoking indoors but nicotine residues will stick to a smoker's skin and clothing. Those residues follow a smoker back inside and get spread everywhere. The biggest risk is to young children. Dermal uptake of the nicotine through a child's skin is likely to occur when the smoker returns and if nitrous acid is in the air, which it usually is, then TSNAs will be formed." "Whereas the sidestream smoke of one cigarette contains at least 100 nanograms equivalent total TSNAs, our results indicate that several hundred nanograms per square meter of nitrosamines may be formed on indoor surfaces in the presence of nitrous acid," said the study's lead -author Mohamad Sleiman. "What we see in this study is that the reactions of residual nicotine with nitrous acid at surface interfaces are a potential cancer hazard, and these results may be just the tip of the iceberg," said Kamlesh Asotra of the University of California's Tobacco - Related Disease Research Program, which funded the study. "We know that these residual levels of nicotine may build up over time after several smoking cycles, and we know that through the process of aging, third -hand smoke can become more toxic over time," says Hugo Destaillats, a co -author of the study and a chemist with the Indoor Environment Department of Berkeley Lab's Environmental Energy Technologies Division. "Our work highlights the importance of third -hand smoke reactions at indoor interfaces, particularly the production of nitrosamines with potential health impacts." An estimated 53,000 non - smokers die each year in the United States as a result of secondhand smoke exposure, including over 35,000 from coronary heart disease associated with secondhand smoke exposure. The American Heart Association urges legislators to support the passage of Bill 216. Smoking and its inherant dangers is a choice that should be limited to adults. Children should not be subjected to those dangers as a result of the poor health choices made by the adults that surround them. Respectfully submitted, Donald B. Weisman Hawaii Communications and Marketing/Government Affairs Director Please remember the American Heart Association in your will. 0 American Heart American Stroke Association. Association. Learn and Live. Serving Hawaii