• Dr Marion Morkel, Chief Medical Advisor at Sanlam

Second-hand smoke and the rights of non-smokers

Yes, smoking does kill. Despite the alternative facts on the internet or comparisons of how it fares against other drugs, medical evidence remains: smoking cigarettes causes one-third of all cancer deaths. This is according to recent research by the American Cancer Society which found that smoking cigarettes does not only increase the risk for lung cancer, but it can directly cause 12 types of cancers. But while smokers choose to exercise their habit, this Anti-tobacco month, the spotlight needs to focus on the rights of non-smokers, who run the risk of developing health issues from passive smoking.

According to Dr Marion Morkel, Chief Medical Advisor at Sanlam, while we are all susceptible to the risks associated with second-hand smoke, healthcare workers are particularly concerned about children, pregnant women, the elderly and those with pre-existing health conditions.

Who is most at risk?

“Sadly, children are least able to avoid second-hand smoke and they’re also most at risk if their parents are smokers. Organs that are still developing and growing mean the cells are more vulnerable to second-hand smoke,” says Morkel. The effects are not limited to obvious health challenges either. “Exposure to second-hand smoke in children is also linked to learning ability at school as well as mood swings. Tragically in newborn babies, second-hand smoke has been linked to sudden infant death syndrome,” she adds.

For pregnant mothers, second-hand smoke can interfere with the growth of the foetus as well as the health of the placenta that provides nourishment to the unborn baby. Meanwhile, for sick adults and the elderly, frail and vulnerable organs mean they’re more susceptible to the risks associated with exposure to second-hand smoke too.

Stricter smoking laws will help prevent associated diseases

The proposed tightening of laws governing smoking in South Africa has been welcomed by the medical fraternity. With proposals such as a complete ban on outdoor smoking in public places and the removal of cigarettes from public display by retailers, Dr Morkel says the government might ultimately achieve to reduce the prevalence of smoking in the country.

Considering that studies show a correlation between the extent children are exposed to smoking adults, and of becoming smokers later in life, Dr Morkel says the sooner these laws come into place, the better. “Smoking is driven far more by copying the behaviour of the adults in their life rather than just the inhalation of the smoke,” says Morkel.

Could insurance companies penalise passive smokers?

Leading healthcare organisations across the world – including the World Health Organisation (WHO), the Centre for Disease Control (CDC), and cancer foundations within every country – have conducted numerous studies into the diseases associated with smoking and passive smoking. Virtually every cancer in the body has some associated risk with smoking, while lung cancer has one of the highest associations with smoking.

“There are also multiple medical conditions including cardiovascular disease, lung disease and even psychiatric conditions that are all either caused by or exacerbated by both smoking and second-hand smoking,” says Morkel.

It is therefore not surprising that one of the key questions insurers ask prospective clients is about their smoking status. Smokers pay an increased premium which is based on actuarial calculations that consider the complications and claims experience of smokers both in insurance medicine and clinical settings. While passive smoking isn’t currently taken into account – for example, insurers don’t ask if either of your parents were smokers – insurers are increasingly looking at this burden and considering whether there is a way to consider the underwriting of this unfortunate health risk.

Smoking is a controversial topic, perhaps mostly for smokers who feel their rights are violated by tightening laws. But we really do need to consider the innocent victims of passive smoking, says Morkel. “Smoke lingers long after the smoker has stopped smoking and studies have shown that even with good ventilation the average ‘life of the smoke air’ has been in excess of two hours or more. It’s high time that those who actively choose not to smoke or are too young to even have a say, are protected from the risks of second-hand smoke,” she concludes.


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