When Joyce Bushman lost her husband, Thomas, to lung cancer 10 years ago, he was 43 and hadn’t smoked a cigarette in his life.

Though she’ll never know the exact cause of the disease that left her a widow with two young children, the Pickerington woman wonders whether the years Tom spent hanging out in his father’s Wisconsin tavern as a young boy took their toll three decades later. "You just feel that there is something in the environment that triggered it. It doesn’t make sense that someone who never smoked got lung cancer," said Bushman, Mayor Michael B. Coleman’s assistant chief of staff. At the heart of a proposal to ban smoking in Columbus workplaces is evidence that cigarettes hurt not just smokers but everyone around them. About 22 percent of adults smoked in Franklin County in 2002, according to the Columbus Health Department. In restaurants, bars and other places, nonsmoking customers are harmed, even by just minutes of exposure, experts say. The toll is even worse for bartenders, bowling alley clerks and servers. The Ohio Bureau of Workers’ Compensation gets few claims related to secondhand smoke exposure and has never allowed one, spokesman Jeremy Jackson said. "The worker has to prove that the secondhand smoke in the workplace was directly or proximately causing the injury and they didn’t come in contact with it anywhere else," he said. "It’s very difficult to prove." But that doesn’t mean it doesn’t happen. According to a landmark 1993 report from the U.S. Environmental Protection Agency, about 3,000 lung-cancer deaths a year can be blamed on secondhand smoke. Further, the EPA estimated that each year between 150,000 and 300,000 cases of lower respiratory tract infections in babies are linked to tobacco smoke. Between 7,500 and 15,000 of those require hospitalization, the agency reported. Studies have accumulated since the EPA report, revealing more details. A comprehensive new report from California’s EPA says that lung, breast and nasal cancers conclusively are linked to secondhand smoke, as are ear infections, asthma, coronary heart disease and blood-vessel abnormalities. In adults, the most serious concerns are lung cancer and coronary heart disease, said Mary Ellen Wewers, a tobacco researcher and nursing professor at Ohio State University. In April, the Centers for Disease Control and Prevention warned for the first time that people at risk of heart disease should avoid places that allow indoor smoking. The advisory was linked to a much-discussed study out of Helena, Mont., that found a drop in heart attacks after a smoking ban and a spike in cases when the ban was lifted. The findings come with a caveat the study included only 25 people who had a heart attack during the short ban but have sparked much discussion nationally and have helped fuel the argument for smoke-free workplaces. In children, whose exposure often comes from their parents’ smoke, top concerns are respiratory infections and asthma, Wewers said. The most damage is done by side-stream smoke, which comes off the end of a cigarette. The other component, exhaled smoke, is filtered and not as harmful, Wewers said. The damage is cumulative, meaning any exposure, even 30 minutes in a smoky bar for an after-work beer, is harmful, she said. In other cases, the damage is immediate, "especially for people who have conditions such as asthma. . . . The tobacco smoke itself acts as an irritant." "I don’t think there’s any safe level of exposure. It’s a carcinogen," Wewers said. When smoke hits the surface of the lung in smokers and nonsmokers alike, cellular damage is immediate, said Dr. Zab Mosenifar, executive vice president of the Department of Medicine and director of pulmonary medicine at Cedars-Sinai Medical Center in Los Angeles. "I see many patients, many patients who have had only exposures to secondhand smoke and they have symptoms that are apparent by 35, 40 cough, phlegm, limitations on exercise," Mosenifar said. "Their daily living becomes problematic. "I’m a nonsmoker myself. My father’s dead, I’m 50-some years old and I still resent that for the first 14 years of my life I was exposed to his secondhand smoke." mcrane@dispatch.com

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