Genotoxic risk of passive smoking

More than 60 chemical components are identified in cigarette smoke which have shown to be carcinogenic. The presence of these chemicals is established in mainstream smoke. However, many of them also appear in sidestream smoke resulting in pollution of indoor air, as is shown by the presence of mutagenic substances. Some rather potent carcinogens like N-nitroso-dimethylamine and benzo(a)pyrene have been established in the air of smoke filled rooms. Only a few studies describe internal exposure of passive smokers. Deposition of sidestream smoke in the human respiratory tract has been established for passive smokers. On the other hand, it was shown that inhalation of air contaminated with sidestream smoke results in an increase in the urinary excretion of products mutagenic in the Salmonella/microsome assay. Three epidemiological studies showed an increased risk of lung cancer for non-smoking wives having smoking husbands. Since it is generally acknowledged that most of the genotoxic carcinogens can be detected by in vitro mutagenicity tests, mutagenicity in urine of passive smokers can be considered as an indication of exposure to carcinogens. This observation suggests that there is a causality in the association between increased cancer risk and passive smoking as was found in three epidemiological studies. It is generally accepted that genotoxic chemicals exert their effects in direct proportion to the level of exposure, which means that for these agents no safe thresholds can be established. Several studies clearly show the presence of genotoxic substances in indoor air as a consequence of smoking. Therefore, the outcome of the epidemiological studies is not surprising. As long as half of the human population persists in smoking, the problems of involuntary inhalation of genotoxic substances will continue for the other half. Strategies to control the environmental cancer problem can only be successful if the health hazards of passive smoking are taken seriously.