» return to summaries list

Antioxidants and the Passive Smoker

Health agencies and the private sector having become very active in the study and control of environmental tobacco smoke. Despite increasing the number of restrictions on smoking in public buildings and transportation, healthcare institutions, hotels and restaurants, a major health concern also relates to exposure to environmental tobacco smoke in the home, especially for infants and children. When regulatory agencies and public measures to control environmental tobacco smoke fail, preventative modalities and therapeutic maneuvers need supervene to protect the innocent non-smoker, recognized today as “passive” or “secondary” smoker. Particularly vulnerable are infants and children where environmental tobacco smoke has been linked to increased risks of low birth weight babies, sudden infant death syndrome, bronchitis and pneumonia and a cause of asthma with complicated repeated asthmatic attacks.

Various epidemiologic studies have issued the alert that passive smokers are indeed at a higher risk than non-smokers for tobacco associated diseases, particularly from the so-called “side stream” smoke which emanates from cigarettes between puffs by the smokers. The primary smoker is also markedly afflicted by “mainstream” smoke, which he or she inhales with each puff. A recent epidemiologic study on passive smokers showed the risk for coronary heart disease in women who had never smoked was doubled compared to non-smokers. Similar claims have been launched by airline stewardesses. Studies in Chinese women also revealed a risk for coronary heart disease in those exposed to environmental tobacco smoke at work. More recently, these clinicians showed that there were a greater number of narrow coronary arteries for lifelong non-smoking wives from exposure to their husband’s smoking.

Investigators at the University of Nevada evaluated the stress created by the pervasive contaminant environmental tobacco smoke in the workplace. They measured blood levels of various antioxidants and a “guanosine” molecule as a marker of DNA damage to cells. The level of this reflector of free radicals in the subjects exposed to environmental tobacco was more than 60 percent higher than in non-exposed control individuals. Subsequently, these workers were started on a nutritional supplement of vitamins C and E, Beta carotene, zinc, selenium and copper for 60 days and the laboratory studies were then repeated. There was evidence that fewer free radicals were generated now by environmental tobacco smoke exposure, since damage to cell membranes (lipid peroxidation) and the levels of the “guanosine” marker of DNA damage were marked diminished. The levels of the antioxidants in blood were now also lower. The researchers concluded that exposure to environmental tobacco smoke in the workplace increases oxidative stress, accounting for the increased risks of tobacco related diseases noted in secondary smokers. They also showed that supplementation with antioxidants, including selenium, provided some degree of protection to these secondary smokers.

How can we protect the passive smoker? The easy answers are obvious: Smoking cessation by individuals or institution by law of tobacco prohibition. Neither seem viable alternatives. Then, realistically what is the passive smoker to do?

Tobacco smoke generates toxic oxygen and other free radical species, which damage cells, interfere with metabolic processes and cause “breaks” in DNA, which may result in mutations and malignancies. The body has a well developed antioxidant system to scavenge and neutralize the injurious free radicals generated by tobacco smoke and other environmental pollutants. It is known that smokers have low blood levels of antioxidants, including vitamin C and L-glutathione, the body’s most important antioxidant.

Nutritionists have long advised us on a diet high in fruits and vegetables to keep us healthier and younger. Eating fruits and vegetables naturally also tends to lower our intakes of meats, fats and cholesterol, the modern villains of nutritionally induced diseases. The former foodstuffs are well known to contain potent antioxidants including phytochemicals and ascorbic acid. Some have unique molecules such as bio-flavonoids like lycopene in tomatoes and proanthocyanidins in grapes.

But the real winner, we think, is the body’s best-kept secret, the ubiquitous antioxidant L-glutathione. This sulfur containing tripeptide is the gatekeeper antioxidant in body fluids and in each and every cell. Dr. Dean P. Jones at Emory University has shown that fruits and vegetables contain high concentrations of L-glutathione. A diet high in fresh fruits also has been shown to help improve lung function in children with asthma. Oral consumption of L-glutathione, teleologically provides the body with its best antioxidant defense. L-glutathione however, also needs other enzymes and vitamins C and E to work together for the cell’s defense against the free radicals generated in the passive smoker by environmental tobacco smoke and other pollutants.

While science continues to study the value of L-glutathione, unprotected non-smokers may be helped by consuming foods rich in L-glutathione, like fruits and vegetables. In addition, the passive smoker may also take orally a complete complex of antioxidants to replenish body stores. They may also locally spray and chew tablets with these antioxidants for beneficial and protective effects to the oro-pharynx, the gateway to tobacco smoke. In the meantime, let us not decrease campaigns for reducing environmental tobacco smoke and smoking cessation programs, drugs or devices for the tobacco smoker. Passive smokers beware! Until the primary smoker stops his/her tobacco habits, chew, swallow, and spray with your antioxidants and vitamins.

» return to summaries list