Tobacco Green Facts

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Tobacco : Level 1 - Summary on Study Name

ome > Studies > Tobacco > Level 1

Scientific Facts on

TobaccoActive and Passive Smoking

Source document:IARC (2002)

Summary & Details:GreenFacts (2004)

About this study

Info on our studies structure

Context - Over one thousand million peopleworldwide smoke tobacco.

In developed countries, the overall percentage ofsmokers has decreased, but the persentage isstill increasing in developing countries andamong women.

More and more is known about the harmfuleffects of tobacco on smokers.

Are passive smokers also at risk?

Questions on Tobacco

1. What are the current trends in active tobacco

smoking?

2. What kinds of cancer does tobacco cause in

smokers?

3. Does tobacco cause cancer in test animals?

4. What other biological effects can active smoking

cause?

5. What is passive smoking?

6. Does passive smoking cause cancer?

7. Does passive smoking cause other health effects

8. Conclusions on tobacco and cancer

9. Other views

This study is a faithful summary of the leading scientific consensus report

produced in 2004 by the IARC (International Agency for Research on Cancer):

"Volume 83 Summary of data reported and evaluation on Tobacco Smoke and Involuntary Smoking" More...

Level 1 Questions More in Details

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. What are the current trends in active tobacco smoking?

1.1. Over one thousand million people worldwide smoke tobacco. The percentage of smokers has decreased indeveloped countries, but is increasing in developing countries and among women. More...

1.2. Tobacco is mainly smoked as cigarettes, but also as pipes, cigars or bidis. More...

1.3. All current tobacco products expose smokers to chemicals which can cause cancer. The amounts of harmful

substances to which smokers are exposed depend on the type of tobacco, the way it is smoked, product design andwhether filters are used. More...

Conclusion Level 1 Questions More in Details

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2. What kinds of cancer does tobacco cause in smokers?

2.1.Tobacco smoking strongly increases the risk of developing cancer of the lung, oral cavity (mouth), pharynx,

larynx, oesophagus, pancreas, bladder and renal pelvis (the kidney outlet). It also increases the risk of cancers of t

nasal cavities (nose) and sinuses, stomach, liver, kidney, cervix (neck of the uterus) and bone marrow (myeloid

leukaemia).

The risk depends on how long a person has been smoking and the number of cigarettes smoked. For some cancers

alcohol consumption increases the risk. More...

2.2. There is evidence suggesting that tobacco smoking does not cause breast cancer and that it reduces thefrequency of cancer of the lining of the uterus. More...

2.3. No clear link has been found between smoking and colorectal cancer or prostate cancer. More...

2.4. Smoking cigars, pipes or bidis also causes a variety of cancers. More...

2.5. The risk for developing particular types of cancer can be amplified when smoking is combined with exposure to

some substances in the workplace, alcohol consumption or some viral infections. More...


Next Question Top


Laboratory tests have shown that tobacco smoke and tobacco smoke condensate cause cancer in many kinds of tes

animals, such as rats and mice. More...


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Next Question Top

4. What other biological effects can active smoking cause?

In humans, active smoking can cause pregnancy problems, as well as diseases of the respiratory and cardiovascula

systems.

Nicotine is the main component which makes tobacco addictive. Harmful substances from tobacco smoke and theirbreakdown products are present in the urine and blood stream of both active and passive smokers. In the body,

carcinogens from tobacco smoke can bind to blood proteins and to DNA, and can thus produce genemutations and

chromosomal abnormalities. Smoking can also cause changes in the metabolism ofcells or tissues, resulting in

changes to the way foreign substances are broken down by the body. More...


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Passive smoking is involuntary exposure to tobacco smoke. The secondhand smoke inhaled by passive smokers is a

mixture of smoke exhaled by smokers and smoke directly released from smouldering tobacco. It contains nicotine awell as various carcinogens and toxins. More...


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6.1. There is sufficient evidence to conclude that there is an increased risk of lung cancer for people who have neve

smoked but who have been exposed to tobacco smoke, e.g. spouses of smokers and non-smokers exposed at the

workplace. However, the risk is much smaller than for active smokers. More...

6.2. For other cancers such as breast and childhood cancer, however, evidence is not conclusive. More...

6.3. Studies on laboratory animals support the evidence that passive smoking can cause cancer in humans and ther

is some data suggesting that dogs living in smoking households also have an increased risk for certain cancers.More...


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7. Does passive smoking cause other health effects?

7.1. Passive smoking can cause coronary heart disease and chronic respiratory symptoms. More...

7.2. Though Passive smoking does not seem to affect body weight, fertility and age at menopause of women, the

birth weight of babies born to passive smokers may be lower than those born to non-smokers. More...

7.3. Similar to active smokers, passive smokers have harmful substances and breakdown products of tobacco smokein their body, which can cause cell damage and lung cancer. More...

7.4. Test animals exposed to secondhand tobacco smoke show a range ofadverse effects, including DNA damage,

altered metabolism, reduced birth weight, as well as diseases of the arteries and the respiratory system. More...


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8.1. There is sufficient evidence to conclude that tobacco smoking causes several types ofcancer in humans. More.

8.2. Moreover, there is sufficient evidence to conclude that passive smoking causes lung cancer in humans.

The International Agency for Research on Cancer (IARC) has therefore classified both active and passive tobacco

smoking and tobacco smoke as "carcinogenic to humans"

(Group 1). More...


p

9. Other Views

This study is based on the latest International Agency for Research on Cancer ( IARC) study on Tobacco (2004). It is

generally considered as a consensus document and some recent scientific assessments reach similar conclusions -

click here for some links.

However, some people and organizations suggest that tobacco poses fewer risks - click here for a link.

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GreenFacts ToolBox

About the Toolbox | Back | Print | Forward

Other Views onTobacco

The links on this page have been selected as examples of other views on Tobacco.This list of links is only a sample and neither pretends to be complete nor fully representative of all the views available.

GreenFacts Foundation takes no position concerning the views expressed in these linked documents.

onclusions of some other recent reports

The report of the U.S. Surgeon General on the Health Effects of Smoking (2004) documents the other advereffects of active smoking (cardiovascular, respiratory and reproduction and fertility) in addition to the effectcancer incidence which are covered in the IARC report.

www.cdc.gov/tobacco/sgr/sgr_2004

California EPA report on passive smoking (1997)www.oehha.org/air/environmental_tobacco/finalets.html

WHO report on passive smoking (2000) of the Regional Office for Europe

www.euro.who.int/document/aiq/8_1ets.pdf

site presenting and critiquing views that Tobacco poses less risks

The UK Select Committee on Health in its report "The Tobacco Industry and the Health Risks of Smoking"

presents and critiques the views of the tobacco industry on the health riskswww.publications.parliament.uk/pa/cm199900/cmselect/cmhealth/27/2709.htm#a6

Back | Print | Forward Top

29-Dec-2004

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Tobacco : Level 2 - Details on Tobacco

ome > Studies > Tobacco > Level 2 > Questions

Scientific Facts on




About this study

Info on our studies structure

Level 2 - Details on Tobacco

q 1. What are the current trends in active tobacco smoking?

r 1.1. How many people actively smoke tobacco?

r 1.2. In what forms is tobacco smoked?

r 1.3. What affects exposure to tobacco?

q 2. What kinds of cancer does tobacco cause in smokers?

r 2.1. Which cancers are caused by cigarette smoking?

r 2.2. Which cancers do not appear to be caused by cigarette smoking?

r

2.3. For which cancers does a link remain unclear?r 2.4. Does cigar, pipe or bidi smoking also cause cancer?

r 2.5. Are there synergies between smoking and other causes of cancer?

q 3 . Does tobacco cause cancer in test animals?

q 4. What other biological effects can active smoking cause?

q 5. What is passive smoking?

q 6. Does passive smoking cause cancer?

r 6.1. Does passive smoking increase the risk of lung cancer?r 6.2. What is known about passive smoking and other human cancers?

r 6.3. Does passive smoking cause cancer in animals?

q 7. Does passive smoking cause other health effects?

r 7.1. Does secondhand smoke affect the heart and the respiratory system?

r 7.2. Does secondhand smoke affect women or the unborn child?

r 7.3. What other health effects are caused by secondhand smoke?

r 7.4. Does secondhand smoke cause biological effects in animals?

q 8. Conclusions on tobacco and cancer

r 8.1. Conclusions on active smoking

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Tobacco : 1. What are the current trends in active tobacco smoking?

ome > Studies > Tobacco > Level 2 > Question 1

Scientific Facts on




About this study

Level 1 Questions Next Question

. What are the current trends in active tobacco smoking?

1.1. How many people actively smoke tobacco?

1.2. In what forms is tobacco smoked?

1.3. What affects exposure to tobacco?

.1. How many people actively smoke tobacco?

Over one thousand million people worldwide smoke tobacco. The percentage of smokers has declined in manydeveloped countries but is increasing in developing countries. In most populations, 20 to 66% of men smoke. Eventhough the share of women who smoke is increasing, this percentage is generally lower than among men. More...

Back to Summary Level 2 Questions More in the Source Document

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.2. In what forms is tobacco smoked?

Tobacco is most commonly smoked as manufactured or hand-rolled cigarettes. Other products, such as pipes, cigarsand bidis are used less commonly or predominantly in particular regions. More...


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Tobacco : 1. What are the current trends in active tobacco smoking?

.3. What affects exposure to tobacco?

All current tobacco products expose smokers to carcinogens. The composition of tobacco smoke depends on the typ

of tobacco, the design of the smoking device, the presence of filters (in the case of cigarettes) and other factors(paper porosity, types of additives, ventilation, etc).

The yields of tar, nicotine and carbon monoxide from cigarettes have fallen over recent decades in most parts of theworld. However, the amounts of tar and nicotine released by cigarettes are not helpful in assessing actual exposure

to carcinogens in tobacco smoke. The actual doses of nicotine, carcinogens and toxins smokers are exposed todepend on the total volume of smoke drawn from cigarettes, which is determined by smoking intensity and method.More...


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07-Jan-2005

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9/28

Tobacco : 2. What kinds of cancer does tobacco cause in smokers?


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About this study

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2. What kinds of cancer does tobacco cause in smokers?

2.1. Which cancers are caused by cigarette smoking?

2.2. Which cancers do not appear to be caused by cigarette smoking?

2.3. For which cancers does a link remain unclear?

2.4. Does cigar, pipe or bidi smoking also cause cancer?

2.5. Are there synergies between smoking and other causes of cancer?

Nearly 20 years ago, the International Agency for Research on Cancer (IARC) reported that tobacco smoking

increased risks of cancers of the lung, oral cavity (mouth), pharynx, larynx, oesophagus (squamous-cell carcinoma)

pancreas, bladder and renal pelvis (the kidney outlet). Smokers are much more likely to develop these cancers thannon-smokers: between 3 times more for pancreas cancer and 20 times more for lung cancer.

It is now established that tobacco smoking also increases by about 2 to 3 times the risk of getting cancers of the

nasal cavities (nose), nasal sinuses, oesophagus (adenocarcinoma), stomach, liver, kidney and cervix (neck of the

uterus) and developing myeloid leukaemia. More...

See table



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10/28


11/28


2.1.12 Bone marrow (leukaemia): Adult myeloid leukaemia is causally related to smoking. No clear evidence has

been found for a link with lymphoid leukaemia or lymphoma. More...



2.2. Which cancers do not appear to be caused by cigarette smoking?

Most studies have found no association of breast cancer with smoking. Moreover, smoking appears to reduce the

frequency of cancer of the lining of the uterus, especially after menopause. More...



2.3. For which cancers does a link remain unclear?

It is not clear whether cigarette smoking increases the risks of colorectal or prostate cancer due to the presence of

confounding factors (additional variables that may be responsible for the effect). More...



2.4. Does cigar, pipe or bidi smoking also cause cancer?

Cigar and/or pipe smoking cause cancers of the oral cavity (mouth) and the upper digestive tract (oropharynx and

hypopharynx, larynx and oesophagus). The risk increases with the amount smoked and when smoking is combined

with alcohol consumption. Cigar and/or pipe smoking also causes lung cancer and there is evidence that it may causpancreatic, stomach and bladder cancer.

Bidi smoking causes cancer of the oral cavity (mouth), upper digestive tract (pharynx, larynx and oesophagus), lun

and stomach. The risk increases with duration and amount of bidi smoking. More...


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12/28


2.5. Are there synergies between smoking and other causes of cancer?

The combination of different cancer factors can produce an effect greater than the sum of their individual effects.

In particular, synergies have been found between smoking and:

q exposure to arsenic, asbestos and radon at the workplace for lung cancer;

q alcohol consumption for cancers of the oral cavity, pharynx, larynx and oesophagus;

q human papillomavirus infection for cervix cancer (neck of the uterus).

The evidence for synergy was inconclusive for other factors, such as hepatitis B and alcohol for liver cancer. More...





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13/28

Tobacco : 3. Does tobacco cause cancer in test animals?


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About this study



Effects of tobacco smoke on test animals are not fully representative of those in humans, because exposure and

tumour development are different. Nevertheless, results of animal studies help to understand the carcinogenic

potential of tobacco smoke.

Different animal species exposed to tobacco smoke in different ways may develop tumours. Hamsters consistently

developed tumours of the larynx, while some of the studies on rats and mice showed small increases in lung

tumours. The evidence for malignant lung tumours in dogs is more uncertain.

Cigarette smoke condensate both initiates and promotes tumour development in animals. It has caused skin tumou

in mice and rabbits when applied to skin, tumours of the lung and lymph system in mice when applied to the mouth

and lung tumours in rats when injected into the lungs. Condensate from bidi smoke also induced tumours in severaorgans in mice.

Collectively, these results provide evidence of the carcinogenic effect of tobacco smoke in test animals. More


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14/28

Tobacco : 4. What other biological effects can active smoking cause?


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About this study


4. What other biological effects can active smoking cause?

Active smoking causes adverse reproductive outcomes and various health effects other than tumours, including

respiratory and cardiovascular diseases.

Nicotine is the major addictive component of tobacco. In the human body, it is transformed into the metabolite

cotinine, which is used as a reference to indicate exposure to tobacco smoke since it is found only in smokers and in

passive smokers (in blood, urine and saliva).

Air exhaled by smokers contains higher concentrations of the following chemicals: carbon monoxide, benzene and

volatile organiccompounds. Moreover, some important carcinogens present in tobacco smoke and their metabolites

are found in the urine of smokers.

Carcinogens present in tobacco smoke can react with proteins and DNA to form "adducts". Such carcinogen adducts

are present in many tissues of smokers at higher levels than in non-smokers, for instance in the respiratory tract,

bladder and cervix (neck of the uterus). Some but not all studies have also found adducts in the umbilical cord blood

of smoking mothers and in cardiovascular tissues. Adducts can damage cells by producing genemutations and

chromosomal abnormalities.

Smoking can alter the activity of many enzymes involved in normal body metabolism.

In humans, smoking produces genemutations and chromosomal abnormalities. Urine from smokers is mutagenic.

Relative to non-smokers, lung tumours of smokers have unique features specific to exposure to tobacco smoke.

Tobacco smoke is genotoxic in humans and in test animals.

In test animals, exposure to tobacco smoke also alters a variety ofenzyme activities, results in formation ofDNA

adducts in several tissues and alters lung function. More...




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tmhttp://www.greenfacts.org/index.htm


15/28

Tobacco : 4. What other biological effects can active smoking cause?


07-Jan-2005

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16/28

Tobacco : 5. What is passive smoking?


Scientific Facts on




About this study



Passive (or involuntary) smoking is exposure to secondhand smoke, also called environmental tobacco smoke. Su

smoke is a mixture of smoke exhaled by smokers and smoke released from the smouldering cigarettes, cigars, pipebidis, etc.

Secondhand tobacco smoke consists of both gases and particulates, which change as they get diluted and distributein the environment and with time. The quantity of secondhand smoke inhaled involuntarily varies and its compositiodepends on smoking patterns and cigarette type. Concentrations in air may be elevated substantially in enclosed

spaces.

Secondhand smoke contains nicotine, as well as various carcinogens and toxins. Nicotine concentrations in the air in

workplaces where smoking is permitted and in homes of smokers range on average from 2 to 10 g/m 3. More





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17/28

Tobacco : 6. Does passive smoking cause cancer?


Scientific Facts on




About this study



6.1. Does passive smoking increase the risk of lung cancer?

6.2. What is known about passive smoking and other human cancers?

6.3. Does passive smoking cause cancer in animals?

6.1. Does passive smoking increase the risk of lung cancer?

Passive smoking involves exposure to the same numerous carcinogens and toxic substances which cause lung cance

in smokers. This implies some risk of lung cancer from exposure to secondhand smoke.

More than 50 studies have been published on lung cancer risk in people who have never smoked but who have been

exposed to tobacco smoke, especially spouses of smokers. Most studies show an increased risk, particularly forpersons with higher exposures. The overall finding is an increased risk of lung cancer in spouses of smokers of 20%in women and 30% in men. Non-smokers exposed at the workplace have a 12-19% increased risk of lung cancer.

This evidence is sufficient to conclude that passive smoking is a cause of lung cancer in never-smokers. More



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18/28

Tobacco : 6. Does passive smoking cause cancer?

6.2. What is known about passive smoking and other human cancers?

The evidence of a possible link between breast cancersand passive smoking is inconsistent. Some studies have

reported an increased risk, but this has not been confirmed by other large studies. Moreover, the lack of association

between active smoking and breast cancer argues against a risk from passive smoking. Data are conflicting andsparse for cancers in other parts of the body.

Evidence for an association ofchildhood cancer and parental smoking is inconsistent and may be biased. A

possible link between maternal smoking during pregnancy and childhood cancer has been suggested. Some studiesalso suggested that paternal smoking may be linked to a small increased risk for cancer of the lymphatic system, bu

results may have been biased. More...


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6.3. Does passive smoking cause cancer in animals?

In laboratory experiments, animals are exposed to mixtures of smoke produced by machines to simulate secondhansmoking. Though such experiments do not fully simulate human exposure and the tumours induced are not

completely representative of human cancer, results of animal studies help to understand the carcinogenic potential

secondhand tobacco smoke.

Lung tumours have been induced in mice when exposed to such tobacco smoke mixtures under different conditions

Cigarette smoke condensates derived from sidestream and/or mainstream smoke produced skin tumours in mice

when applied on the skin and lung tumours when injected into the lungs. An increased risk of cancer has been

reported in dogs exposed to secondhand tobacco smoke in homes. More...





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19/28

Tobacco : 7. Does passive smoking cause other health effects?


Scientific Facts on




About this study


7. Does passive smoking cause other health effects?

7.1. Does secondhand smoke affect the heart and the respiratory system?

7.2. Does secondhand smoke affect women or the unborn child?

7.3. What other health effects are caused by secondhand smoke?

7.4. Does secondhand smoke cause biological effects in animals?

7.1. Does secondhand smoke affect the heart and the respiratory system?

Exposure to secondhand smoke can cause coronary heart disease, increasing the risk of acute coronary heart diseas

events by 25-35%. Moreover, it can cause chronic respiratory symptoms. More...



7.2. Does secondhand smoke affect women or the unborn child?

There are few data on the effects ofpassive smoking on the hormonal system and on metabolism. Unlike female

active smokers, female passive smokers do not weigh less than non- exposed women. In mothers, no consistenteffects of passive smoking on fertility or fecundity have been found. Similarly, t here is no clear association between

passive smoking and age at menopause.

Babies of mothers who smoke actively weigh about 200g less at birth than those of mothers who are non-smokers.Passive maternal smoking may also lead to a lower birth weight, but to a lesser extent. More...



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20/28

Tobacco : 7. Does passive smoking cause other health effects?

7.3. What other health effects are caused by secondhand smoke?

Carcinogens present in tobacco smoke can react with proteins and DNA to form adducts. Such carcinogen adduct

have been found on blood proteins in passive smokers, children of smoking mothers and to a lesser extent in

umbilical cord blood of smoking mothers. There are no clear differences in the levels ofDNA adducts in the white

blood cells of passive smokers and non-exposed individuals.

The break-down products of a carcinogen specific to tobacco are found in passive smokers, supporting a link betwee

passive smoking and cancer.

Compounds able to damage chromosomes (mutagens) are present at higher concentrations in the urine of passive

smokers than in that of non-exposed individuals.

Moreover, lung tumours found in passive smokers present specific similarities with those of active smokers.

In various in vitro and in vivo laboratory experiments, the smoke to which passive smokers are exposed has been

shown to damage DNA (genotoxic). More...


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7.4. Does secondhand smoke cause biological effects in animals?

In test animals exposure to secondhand tobacco smoke affects various enzyme activities, leads to the formation of

DNAadducts in several tissues and results in urine containing markers of exposure to tobacco smoke. Animals

exposed to secondhand smoke develop inflammation in the airways and a disease of the arteries (arteriosclerosis), a

observed in passively exposed humans. Exposure to sidestream smoke was also reported to lower birth weight, altelung enzymes during development, abnormally increase the number of certain lung cells and alter the function of th

lung. More...





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Tobacco : 8. Conclusions on tobacco and cancer


Scientific Facts on




About this study

Previous Question Level 1 Questions


8.1. Conclusions on active smoking

8.2. Conclusions on passive smoking

8.1. Conclusions on active smoking

There is sufficient evidence in humans that tobacco smoking causes cancer at many sites, i.e. lung, mouth, pharynx

nose and paranasal sinuses, larynx, oesophagus, stomach, pancreas, liver, urinary tract ( bladder, ureter and

kidneys), cervix (neck of the uterus) and bone marrow (myeloid leukemia). There is evidence suggesting that

tobacco smoking does not cause breast cancer or cancer of the uterus lining in women.

There is sufficient evidence in test animals that tobacco smoke and tobacco smoke condensates are carcinogenic.

Therefore, the International Agency for Research on Cancer (IARC) has classified tobacco smoking and tobacco

smoke as carcinogenic to humanss (Group 1). More...


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Tobacco : 8. Conclusions on tobacco and cancer

8.2. Conclusions on passive smoking

There is sufficient evidence in humans that passive smoking causes lung cancer.

In test animals, there is limited evidence that mixtures ofmainstream and sidestream tobacco smoke are

carcinogenic but there is sufficient evidence that sidestream smoke condensates are carcinogenic.

In addition, possible carcinogenic effects ofsecondhand smoke in household pet dogs were noted.

Therefore, the International Agency for Research on Cancer (IARC) has also classified passive smoking as

"carcinogenic to humans" (Group 1).More...


Previous Question Level 1 Questions



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