Secondhand Smoke and Atherogenic Changes
in LDL Cholesterol

Miia Valkonen and Timo Kuusi
Circulation 1998;97:2012-2016

Valkonen and Kuusi exposed 10 nonsmokers to secondhand smoke, took blood samples 1.5 hours and 6 hours after exposure, and then measured changes in blood chemistry. And guess what?

It changed. Imagine that. People were exposed to a foreign substance and their bodies reacted. Sounds like a Nobel Prize to me -- NOT!

Exposure to secondhand smoke was not reported to change serum lipid, vitamin E, retinol and beta-carotene concentrations. But it was reported to lower serum ascorbic acid (vitamin C) levels by one-third. But I think this is a good thing. It shows the ascorbic acid in study subjects' serum is removing the free radicals from the secondhand smoke.

Valkonen and Kuusi conclude that "These data provide the pathophysiological background for the recent epidemiological evidence about the increased [coronary heart disease] risk among passive smokers.

I'm not exactly sure what epidemiology they're referring to. As far as I can tell the epidemiology on secondhand smoke and heart disease is roughly the same as that for active smoking and heart disease. If their premise is true, this parity rather strange when you consider that active smokers are exposed to their own secondhand smoke as well as smoking.

But here's the nail-through-the-heart of this study. It is vitamin E that is most strongly associated with protecting against heart disease, not vitamin C. The data on vitamin C is much less compelling. And note that in this study, vitamin E levels were unaffected by exposure to secondhand smoke.

Finally, Valkonen and Kuusi state that "Furthermore, the oxidative stress induced by [secondhand smoke] may have a more prominent effect on a nonsmoking subject than on an active smoker whose cardiovascular system has adapted to [cigarette smoke]." What nonsense. If a smoker can adapt to smoking, a regularly exposed secondhand smoker can probably do the same.

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