Wall Street Journal

January 15, 1998

New Smoking Study Likely

To Impact Policy, Litigation

By ROBERT LANGRETH

Staff Reporter of THE WALL STREET JOURNAL

Surprising new findings on the long-term dangers of past cigarette-smoke

exposure will likely alarm many of the 44 million Americans who quit the

habit in the hope of improving future health.

A giant new study published in the Journal of the American Medical

Association (JAMA) Wednesday found that even decades after people

quit smoking they have a 25% higher amount of artery damage than

people who never smoked.

The new research is expected to have a

powerful effect on policy debates and

future tobacco litigation because it is also

the first major study to show a direct

biological link between secondhand

smoke and artery damage. This result is

expected to spur efforts to ban smoking

in all public places, and may ignite a

whole new wave of liability lawsuits from

people who were exposed to

secondhand smoke through no choice of

their own.

'Hard Biological Evidence'

"This is a big-impact study," said Richard

Daynard, a law professor at

Northeastern University and head of the

Tobacco Products Liability Project.

"Now you have hard biological evidence

that [exposure to tobacco smoke] irreversibly damages arteries. The study

likely spells the end of smoking in shared public places in the United

States." Some states, including California, have already banned most

public smoking, and other states will be hard-pressed not to follow, in light

of the new evidence, he predicted.

The research, certain to arm antismoking activists and public health

officials with new ammunition to further restrict smoking, is especially

troubling news for former smokers and those exposed to secondhand

smoke, because there is little they can do to reverse damage they may

have sustained decades ago. Although it is possible for former smokers to

undergo expensive diagnostic tests to identify artery damage, there is no

therapy short of extremely restrictive diets that can consistently reverse

clogged arteries. Clogging or hardening of the arteries leads to heart

attacks and strokes and is the single leading cause of death in America.

As a result, researchers who performed the new study at Wake Forest

University emphasized the need to prevent teens and other young people

from smoking at all because even a few years of cigarette smoke exposure

may cause permanent damage to arteries that carry blood away from the

heart.

Impact on Artery Hardening

Although scientists long ago realized that smoking can vastly increase the

risk of heart disease and lung cancer, this is the first large study to directly

measure smoking's long-term impact on hardening of the arteries.

Researchers emphasize that the new study should not be interpreted as an

argument against quitting, as the artery damage from smoking is cumulative

and only gets worse the longer one smokes.

What can former smokers or those exposed to secondhand smoke in the

past do to reduce their risk of disease? Health experts say that while the

damage cannot be easily reversed, the new findings should alert

ex-smokers and those exposed to the smoke from others to the fact that

they are at higher risk for heart disease and stroke. Consequently, they

should pay extra attention to eating a healthy diet, exercising, and keeping

their cholesterol and blood pressure levels down. Heart specialists also

suggest that those exposed to smoke should inform their doctors so their

higher risk can be monitored.

In the study, the researchers followed 10,914 middle-aged men and

women who were either current smokers, former smokers, non-smokers

regularly exposed to secondhand smoke, or non-smokers not regularly

exposed to secondhand smoke. At the beginning of the study, the

researchers measured the thickness of the walls of a major artery in the

neck where hardening often occurs; they performed another measurement

three years later.

Former Smokers' Arteries

The researchers were not surprised to find that in current smokers arteries

thickened 50% faster over a three-year period than they did in people

who had never smoked. More surprising was that the arteries of former

smokers also hardened some 25% faster over the three years than

non-smokers -- indicating the damaging effects to arteries can linger for

decades. Finally, arteries of non-smokers exposed to environmental

tobacco smoke thickened 20% faster than non-smokers with no

secondhand exposure.

Previous research had found that heart disease among current smokers is

two to four times greater than heart disease among those who never

smoked and that among those who quit, the risk drops to one that is 20%

higher than the risk among those who'd never smoked. The new study

explains that this lingering effect is due to permanent and visible damage to

the arteries.

The study hints that a significant portion of the 50% of all cases of heart

disease whose cause is now classified as "unknown" may actually be

caused by secondhand smoke exposure, said Thomas Pearson, a

preventive cardiologist at the University of Rochester who wrote an

editorial in JAMA commenting on the Wake Forest study. "If the current

numbers hold, environmental tobacco smoke may be the third leading

cause of death in the United States," he said in an interview.

The new study may propel health agencies to demand additional

compensation from the tobacco industry to help reimburse them for health

costs to people exposed to environmental tobacco smoke. "This could

certainly increase demands for stronger [monetary] concessions from the

tobacco industry," said Richard Hamburg, legislative director for the

American Heart Association.

A spokesman for the Tobacco Institute, a trade organization, said it

wouldn't comment on the study until it performed an independent analysis

of the study.