Smoking kills. The smoker and the people around him. Drains the health of everything in its path. Tobacco use contributes to up to 16 types of cancer and, in particular, is the cause of 80% of lung tumors, and is also a risk factor for other cardiovascular or pneumological diseases. But it harms not only the person who puffs on the cigarette, but also those who are close to it: the scientific community has confirmed that non-smokers exposed to second-hand tobacco smoke on a daily basis have an increased risk of up to 20%. lung cancer and a 25% higher risk of heart attack. The Global Public Health Guidelines have spent years trying to end smoking by creating smoke-free places (schools, hospitals, restaurants and nightclubs…), but there is one place that still refuses to go into that bag: personal automobile. And it won’t be because of the risks. A recent study found high concentrations of nicotine and nitrosamines, which are carcinogens, in tobacco, the air, and on the surfaces of smokers’ vehicles. Experts warn that the impact is short-lived (the duration of the trip), but more intense and affects all passengers.

The harmful power of smoking is not limited to one puff and does not understand active or passive smokers, warns Esteve Fernández, head of tobacco control at the Catalan Institute of Oncology (ICO). “Passive exposure is bad for your health. We have known this since the 1990s,” he notes. For example, it increases the risk of lung cancer, heart attack, or chronic obstructive pulmonary disease (COPD), and worsens asthma symptoms. Children are at increased risk of recurrent acute otitis media, asthma, and respiratory tract infections. “And there is also the effect of passive smoking on pregnant women and the fetus: pregnant women who are passively exposed to smoking have a higher risk of having a baby with a low birth weight and a lower degree of lung maturation,” adds Fernandez.

In closed, small spaces with poor ventilation, exposure to ambient smoke, which results from the burning of a cigarette and what the smoker exhales, increases. And the risks are also growing. Fernandez is one of the signatories of a study coordinated by the Barcelona Public Health Agency and published in a journal. Environmental studies during which they measure the concentration of nicotine in the air and nitrosamines, which are tobacco carcinogens, in private vehicles in Spain and the UK. Some of the powdery compounds deposited on the surface of the car were also measured. “This is a point exposure for a short time (from 15 minutes to an hour), but the impact of which is 6-12 times higher than in the open air. This is a short but intense and recurring exhibition. And the impact is cumulative,” Fernandez warns. A 2011 study by the same researcher found that the prevalence of tobacco use in vehicles was 5.5%, and 2.2% of passengers under the age of 14 were exposed to secondhand smoke inside a vehicle.

“This is a punctual exhibition, but intense and repetitive. And the impact is cumulative.”

Esteve Fernandez, Catalan Institute of Oncology

In this new study, the Barcelona-based scientists measured, among other variables, the concentration of nicotine, which is the addictive component of tobacco. The ICO expert clarifies that no one becomes addicted to nicotine like a passive smoker, “although for ex-smokers, when they passively inhale tobacco smoke, they awaken all their memories and there is a greater risk of re-smoking” – Apostille. “We use nicotine because it’s the best indicator that it was smoked there, but also that which gets into the surrounding smoke starts to oxidize on contact with ambient oxygen and becomes part of the specific nitrosamines. tobacco, which are carcinogens of tobacco, formed during the combustion of tobacco in a cigarette and during the oxidation of nicotine,” explains the ICO researcher.

The concentrations of nicotine and nitrosamines in the vehicles were much higher than those of people who smoked inside the car. And ventilating cars does not eliminate exposure to second-hand smoke, scientists warn. “When the car is running and you drive with the windows half open, the concentration in the front drops a little, but the rear remains the same. From the concentration meter, on which the child sits, the hair stands on end,” Fernandez estimates. Ana Navas-Acien, a researcher in the Department of Environmental Health at Columbia University’s Mailman School of Public Health (USA), agrees that opening windows is not enough: “There’s a very small space in a car, and smoking is there, polluted air is concentrated and people are less likely to avoid breathing this air containing up to 50 carcinogens. Opening the windows doesn’t help because the air doesn’t get out and those toxins don’t come out.”

Residual Smoke Hazard

The worst thing is that all these particles remain in the car, as a kind of reservoir for harmful substances in tobacco smoke. There is residual smoke that does not go away, but settles on fabrics and surfaces, such as seats or, in the homes of smokers, on curtains, fabrics, stuffed animals, carpets, sofa upholstery … ”All carcinogenic toxins go away and get stuck in the upholstery of the car, and when you sit down, they are released again, and the person getting into the car ends up inhaling them,” explains Francisco Pascual, board member of the director of the National Committee for the Prevention of Smoking. Barcelona-based researchers found that concentrations of all residual smoke compounds in cars where drivers reported smoking inside “were six times higher than in non-smoking cars,” the study says.

“Tobacco smoke contains a large amount of toxins, and if there are children nearby, they will breathe in and introduce all this into their bodies”

Ana Navas-Asien, Columbia University

For children, the presence of residual smoke on surfaces is “particularly dangerous” because they are more likely to touch everything and put their hands in their mouths, warns Navas-Acien, White House cancer adviser. “Tobacco smoke contains a large amount of toxins, and if there are children nearby, they will breathe and introduce all this into their bodies,” the researcher insists.

Fernandez highlights the risks associated with smoking, but also warns that it is not safe to use e-cigarettes in a car. In another study, they showed that although there is less nicotine in a smoker’s car, there are also particles in suspension, such as fine particles (PM 2.5). “Particles of 2.5 microns are very small, larger than a lung cell that is five or 10 microns. But these particles hit the lung cells, like throwing a ball into a car. This particle bombardment has an inflammatory effect and can cause cardiovascular problems,” he explains. In addition, these components can “cross the bronchioles and be distributed throughout the body along with the cargo they carry, such as nitrosamines or nicotine,” he adds.

The ICO researcher regrets that in many European countries, including Spain, smoking in personal vehicles is not yet regulated. In Italy it is prohibited when there are children and pregnant women in the car, and in the UK there are also recommendations, but in Spain it is only prohibited in commercial vehicles such as taxis or vans. “Our (anti-tobacco) legislation was good, but there are places that are forgotten, like cars, because they are private places,” he laments. To those who advocate freedom within the framework of private property, Pascual replies: “My freedom ends before your face. The right to health must take precedence over other circumstances.” Fernandez agrees: “You can’t play with your cell phone in the car, you can’t talk on the phone because you’re violating public safety. It’s the same: you can’t smoke, because it increases the accident rate and is harmful to everyone’s health. The right to public health takes precedence over your individual right.” In any case, the most difficult thing will be to enforce this rule, he admits.

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