Even brief exposure to secondhand smoke can increase the stickiness of blood platelets, damage the lining of the blood vessels, slow the flow of blood and impair the heart's ability to respond to the body's oxygen needs.

That led US Surgeon General Richard Carmona to conclude there is no safe level of exposure to secondhand smoke.

"The debate is over as far as I'm concerned," said Carmona. "Based on the science, I wouldn't allow anyone in my family to stand in a room with someone smoking."

Some 126 million non-smokers in the US are exposed to secondhand smoke in their homes and workplaces, putting them at a 20 to 30 percent greater risk for lung cancer and heart disease, according to the report. It attributed an estimated 50,000 deaths each year to secondhand smoke exposure, 430 of them babies who succumb to Sudden Infant Death Syndrome.

Public Policy Implications

The new report comes 20 years after the Surgeon General concluded for the first time that exposure to tobacco smoke causes lung cancer and other ailments in non-smokers. Since then, science has expanded the list of diseases and conditions resulting from exposure to include SIDS, developmental effects in children, heart disease and the risk of other cancers.

The findings have "tremendous public policy implications" and should give ammunition to cities and states trying to enact smoking bans, said Stanton Glantz, director of the University of California at San Francisco's center for tobacco control research and education, who helped draft the paper.

According to the American Nonsmokers' Rights Foundation, 2,282 municipalities have laws that restrict where smoking is permitted. Of those, 219 require restaurants and bars to be smoke-free. Chicago suburbs with such comprehensive laws include Bedford Park, Deerfield, Evanston, Highland Park, Hinsdale and Wilmette.

In December the Chicago City Council voted to phase in a ban on smoking in most public places, though it allowed taverns and restaurants with bars to permit smoking until July 2008. The ordinance also gave establishments the alternative of trying to clean the air with ventilation mechanisms.

The new report concludes, however, that filters are not acceptable because they do not remove all cigarette smoke and even small exposures are dangerous. "I would hope that Chicago and other places that have ventilation provisions would revisit that," Glantz said. "They don't work."

Ventilation Systems

Although the report is mostly a summary of established findings, Glantz said it does a service by highlighting recent work showing the relationship between secondhand smoke and heart disease. Within minutes of inhaling secondhand smoke, a non-smoker's blood vessels become less able to expand, creating effects "very close to those seen in chronic, active smokers," he said.

Even brief exposure to secondhand smoke can increase the stickiness of blood platelets, damage the lining of the blood vessels, slow the flow of blood and impair the heart's ability to respond to the body's oxygen needs, the report found.

Such effects are a big reason why ventilation systems do not reduce the hazards of secondhand smoke, Glantz said. "The toxicity in smoke is so high, even if you get rid of 90 percent of the smoke you still have more than would be considered acceptable," he said.

Illinois Restaurant Association spokesman Andrew Ariens acknowledged that the Chicago ordinance sets a high standard for smoke-removal systems. For a ventilation method to qualify, it would have to make indoor air cleaner than outdoor ambient air, he said.

The law "wasn't really written for today's world," Ariens said. "It gave a two-year grace period so that if any technologies came along, that could change things."

Ald. Burton Natarus (42nd), whose ward includes many restaurants and bars, said in December that the grace period would give the hospitality industry "a chance to prove their case" that ventilation systems can work. Calls to Natarus' office were not returned Tuesday.

Political Decisions

The authors of the Surgeon General's report based many of their conclusions about ventilation on studies by an industry group, the American Society of Heating, Refrigerating and Air-Conditioning Engineers.

One common technique is dilution ventilation, which works by mixing inside air with large amounts of outside air. The report found that the method is often inefficient in practice; even a good dilution system might remove only 63 percent of the original air after an hour.

Such problems were a major reason the society concluded in a separate report last year that "adverse health effects for the occupants of the smoking room cannot be controlled by ventilation."

Although the report leaves little room for advocates of ventilation systems in place of smoking bans, it stops short of calling for policy changes.

"When you get into banning and legislation, those are political decisions made by elected officials," said Carmona. "My job, my responsibility as the doctor of the nation, is to get the best science and information to the public and to the elected officials so that they can make the right decisions."

However, the report does state that "a complete ban on indoor smoking is the most efficient and effective approach to control exposures to secondhand smoke."

A spokeswoman for Philip Morris USA, the nation's leading cigarette maker, declined to comment on the specifics of the report but said the company is reviewing it. Philip Morris has been among the cigarette industry's leading boosters of ventilation as a way to address non-smokers' concerns.

RJ Reynolds Tobacco Co. spokesman David Howard said "we believe proper ventilation does make a difference in being able to provide accommodation for smokers and non-smokers alike." Asked to respond to the claim that ventilation is ineffective, he said: "I am not familiar with specific science studies there have been on that."

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(c) 2006 Daily News Central. All rights reserved.