PASSIVE SMOKING AS A CAUSE OF HEART-DISEASE

The effects of passive smoking on ischemic heart disease are reviewed. Short term exposures of 20 min to 8 h result in increased platelet se nsitivity and decreased ability of the heart to receive and process ox ygen. Longer term exposure results in plaque buildup and adverse effec ts on blood cholesterol. The available epidemiology is reviewed, and i t is concluded that passive smoking increases the coronary death rate among U.S. never smokers by 20% to 70%. The newest Environmental Prote ction Agency procedures for estimating deaths from passive smoking, wh en applied to the epidemiologic results on heart disease and passive s moking, indicate that in 1985 an estimated 62,000 ischemic heart disea se deaths in the United States were associated with exposure to enviro nmental tobacco smoke. Clinicians are advised to counsel their patient s to avoid tobacco smoke at home, at work and in transportation settin gs.