There also are serious health consequences for
nonsmokers exposed to environmental tobacco
smoke (ETS).^132 Children exposed to ETS are at
increased risk of developing acute lower
respiratory infections, ear infections, asthma and
chronic respiratory symptoms,^133 and of
becoming smokers and developing asthma in
adulthood.^134 Exposure to ETS increases the
risk of lung, breast and other cancers, heart
disease, stroke and respiratory illnesses.^135
Recently, the term “third-hand smoke” has been
developed to describe the invisible but toxic
gases and particles--including heavy metals,
carcinogens and radioactive materials--that form
a residue on smokers’ hair, clothing and
household items and remain for weeks or
months after the second-hand smoke has
cleared.^136 Like second-hand smoke, third-hand
smoke is a cancer risk.^137
Alcohol .........................................................................................................................
Alcohol use is the third leading cause of death in
the United States (after tobacco use and poor
diet/physical inactivity) and is responsible for
approximately 3.5 percent of all deaths.^138 An
estimated 98,334 people die from alcohol-
related causes in the U.S. each year, including
chronic diseases (e.g., liver disease, cancer) and
acute causes (e.g., accidents, homicides).^139
(Table 3.11)
Of the 13,555 substance-related traffic fatalities
in 2009, 10,185 involved drivers who were
alcohol impaired (BAC of .08 or higher).^140
Young people are at greater risk of becoming a
victim of an alcohol-related traffic fatality
compared to older people.^141 In 2009, 35
percent of 21- to 24-year old drivers involved in
fatal motor vehicle traffic crashes were under the
influence of alcohol,* more than any other age
group.† 142
- Had a BAC of .08 or higher.
† Compared to 19 percent of 15- to 20-year olds;
33 percent of 25- to 29-year olds; 29 percent of 30- to
34-year olds; 26 percent of 35- to 44-year olds; 22
percent of 45- to 54-year olds; 13 percent of 55- to
64-year olds; and 7 percent of 65- to 74-year olds.
In 2009, alcohol was reported in at least one-
quarter (24.3 percent) of substance-related
emergency department (ED) visits.‡ These
reports, however, significantly underestimate the
prevalence of alcohol-related emergency
department visits for two reasons: the data set
does not include visits linked to alcohol use in
combination with other drugs for persons under
the age of 21, and many EDs do not screen for‡ Measured in terms of patient visits, not individual
drug reports. The analyses of the Substance Abuse
and Mental Health Services Administration, Drug
Abuse Warning Network (DAWN) data assess the
number of drug mentions associated with a drug-
related emergency department visit; up to four drugs
plus alcohol may be recorded for each drug-related
visit.Table 3.11
Average Alcohol-Attributable Deaths in the
United States 2001-2005,
Select ExamplesAverage Deaths
Per Year
Total 98,334
Chronic Causes:
Alcoholic liver disease 12,219
Stroke, hemorrhagic 8,725
Liver cirrhosis, unspecified 7,055
Esophageal cancer 4,225
Alcohol dependence syndrome 3,857
Liver cancer 3,431
Breast cancer (females only) 1,835
Oropharyngeal cancer 1,528
Laryngeal cancer 1,460
Hypertension 1,480
Prostate cancer (males only) 1,025
Acute Causes:
Motor-vehicle traffic crashes 13,819
Homicide 7,787
Suicide 7,235
Fall injuries 5,532
Poisoning (not alcohol) 5,416
Fire injuries 1,158
Drowning 868
Alcohol poisoning 370
Hypothermia 269
Aspiration 204
Child maltreatment 168
Source: CASA Columbia analysis of the Alcohol and
public health: Alcohol-Related Disease Impact (ARDI).