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Expert Q&A

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What are the health risks of secondhand smoke?

Asked by Lauren Conley, Wheeling, West Virginia

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I am 44. I don't smoke and never have, but both my parents did (six packs a day between them), and I am exposed to secondhand smoke at friends' homes.

Do I have the same risk of developing lung cancer as a smoker? What about emphysema? Heart disease? And are there new tests available for my doctor to test me for lung cancer? I heard X-rays are not helpful detecting this. Thank you.

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Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Dear Lauren:

Exposure to secondhand smoke does increase risk of lung cancer, asthma, bronchitis and emphysema as well as heart disease. Recently, secondhand smoke has even been linked to crib death in babies.

Risks for these diseases are not nearly as high as for current or former smokers. As with former smokers, the risk for all of these diseases goes down the longer the time after the exposure. All smokers need to remember that more than one in three will die early from a smoking-related disease.

There are real questions about the efficacy of lung cancer screening.

Some individual physicians advocate spiral CT screening, but none of the respected organizations that make screening recommendations have put lung cancer screening in their guidelines. Screening is not recommended for smokers, nor is it recommended for nonsmokers. Whether screening for lung cancer save lives is the subject of one the U.S. National Cancer Institute's high-priority trials.

We should note that conventional chest X-ray screening for lung cancer was advocated in the 1960s and then abandoned in the mid-1970s as it was determined to not save lives. It did increase the number of people getting biopsies and other invasive procedures.

The public health message is, "Please try to avoid smoke in any form whenever possible. That is the most important thing you can do."

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