The U.S. Surgeon General issued a report this week saying that there is no safe level of exposure to secondhand tobacco smoke and called for legislation and other steps to make more places smoke-free, the Washington Post reported June 28.

"The health effects of secondhand-smoke exposure are more pervasive than we previously thought," said Surgeon General Richard Carmona, who was appointed by President Bush in 2002. "The scientific evidence is now indisputable: Secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults."

The report said that exposure to secondhand smoke raises the risk of heart disease by 25-30 percent and the risk of lung cancer by 20-30 percent among nonsmokers. Carmona said that secondhand smoke also has been linked to sudden infant death syndrome and childhood respiratory problems, ear infections, and asthma attacks.

"Restrictions on smoking can control exposures effectively, but technical approaches involving air cleaning or a greater exchange of indoor with outdoor air cannot," the report said. "Consequently, nonsmokers need protection through the restriction of smoking in public places and workplaces and by a voluntary adherence to policies at home."

Tobacco company R.J. Reynolds contends that the evidence on the health effects of secondhand smoke is inconclusive, but Philip Morris has taken a more conciliatory stance. A Reynolds spokesperson said that the latest report "does not change our views about secondhand smoke."

Carmona accused the tobacco industry of trying to obscure the evidence on secondhand-smoke risks. "The industry has funded or carried out research that has been judged to be biased, supported scientists to generate letters to editors that criticized research publications, attempted to undermine the findings of key studies, assisted in establishing a scientific society with a journal, and attempted to sustain controversy even as the scientific community reached consensus," the report said.

Matthew Myers of the Campaign for Tobacco-Free Kids said the report "once and for all ends any scientific debate about whether exposure to secondhand smoke is a cause of serious diseases like lung cancer and heart disease" and "leads to one inescapable conclusion: Only comprehensive smoke-free workplace laws can protect all workers and the public from the serious, proven health risks of secondhand smoke."

"Public-health advocates will use this report in every state and every city and every workplace, restaurant and meeting place that doesn't already have a comprehensive smoke-free law," predicted Myers. American Medical Association president-elect Ron Davis called Carmona's report "a wake-up call for lawmakers to enact comprehensive clean indoor-air laws that prohibit smoking in all indoor public places and workplaces."