FIGURE 3-1 Potential mode of action of secondhand smoke.

FIGURE 3-1 Potential mode of action of secondhand smoke.

NOTE: Schematic showing cardiovascular effects of secondhand smoke and how they might lead to acute myocardial infarction.

dysfunction, thrombosis, inflammation, hyperlipidemia or other effects (see Figure 3-1). Evidence related to those potential actions is discussed below, followed by a discussion of the effects of the individual constituents of secondhand smoke. Although those physiological changes have been observed and used to assess possible modes of action of secondhand smoke, to date most have not been formally validated as clinical tests and there is not a consensus within the scientific community that they are predictive of actual clinical disease (Ledford, 2008; Wang, 2008; WHO, 2007). Furthermore, a lack of specificity of exposure to secondhand smoke for those markers precludes their use as biomarkers that indicate a given case of cardiovascu-



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