Minnesota doctors and tobacco control advocates say a new federal report on the harmful effects of tobacco smoke should give a significant boost to anti-smoking campaigns.
The report by the U.S. Surgeon General says even occasional exposure to tobacco smoke causes immediate damage that can lead to disease or death.
The report is a comprehensive review of all of the most recent scientific literature on tobacco smoke. That research lays out in stark terms that there is no safe level of tobacco exposure.
Even one cigarette can have a serious effect on a person's fragile lungs and blood vessels.
"They are immediately diminished within the first few minutes of exposure," said Dr. Alan Hirsch, a cardiologist with the University of Minnesota Physicians.
Hirsch treats patients with vascular disease, often caused by smoking. He didn't work on the Surgeon General's report, but he says it's well-documented that chemicals in tobacco smoke quickly inflame delicate tissues and impede blood flow through vessels, and cause arteries to malfunction.
"The mere exposure of your blood to a large number of materials in the tobacco smoke makes the blood more clottable, and exposes the blood to the risk of clot formation that can cause heart attack and stroke," said Hirsch.
“There's no safe level of exposure [to tobacco smoke] ... it's crystal clear.”Dr. Marc Manley, Blue Cross Blue Shield of Minn.
What may be surprising to many non-scientists is that these elevated stroke and heart attack risks occur even with very brief or limited exposure to tobacco smoke.
Dr. Marc Manley, chief prevention officer at Blue Cross Blue Shield of Minnesota, says that should be a wakeup call for anyone who thinks there's a safe exposure level.
"It's especially important for people who may think that they're only smoking a little, or they're only exposed to second-hand smoke and are feeling safe about that," said Manley. "The report makes very clear that there's no safe level of exposure. And I don't think we really knew all the biological reasons for that before. But now it's crystal clear."
The report also outlines how smoking impairs fertility and pregnancy. The chemicals in tobacco smoke can cause miscarriage, preterm birth or reduced infant birth weight. Babies who are exposed to secondhand smoke are also more likely to die from Sudden Infant Death Syndrome.
Dr. Richard Hurt of Mayo Clinic's Nicotine Dependence Center has been sharing this information with his patients as the new data has been published. So far, his patients have had mixed reactions.
"Some are skeptical. But some are really, really concerned. And the more information that they have, the more motivated they become to try to do something about this," said Hurt.
Surveys show that the vast majority of smokers want to quit smoking, but they're battling a powerful addiction.
Pat McKone with the American Lung Association of the Upper Midwest says there's lots of evidence-based research on effective ways to help people quit through counseling and the use of pharmacological drugs.
But she says battling tobacco use is not the same as battling other public health crises.
"Not many health issues have a company as powerful as the tobacco industry, trying to question the science or negate it or minimalize it," said McKone.
Given such opposition and how accustomed people are to smoking and its acceptance in society, she said, anti-smoking advocates have to work hard to not become calloused.
McKone says Minnesota has done good work on the issue. About 17 percent of state residents are smokers, which is lower than the national average of 20 percent. And, Minnesota has strict clean indoor air policies.
But she says the state could do more to discourage smoking by raising the cigarette tax, and spending the $200 million the state receives each year from the tobacco settlement on smoking cessation programs, rather than using the money to plug budget holes.
The Food and Drug Administration has banned cigarettes with flavorings that make them taste better. Last month the agency issued rules requiring graphic images on cigarette packages showing the dangers of smoking.