STATEN ISLAND, N.Y. - One of the biggest threats to clean air is particle pollution from cigarette smoke, local and national experts say.
And it may be one of the reasons why Staten Island, with the highest rate of smokers in New York City, got an "F" in ozone pollution from the American Lung Association's 2018 "State of the Air" report.
"When people pick up that cigarette and start smoking, it really negates the difference of living in Staten Island or living in pollution or not," said Dr. Adam Lackey, thoracic surgeon at Staten Island University Hospital.
The lung cancer rates for both men and women on Staten Island are significantly higher than the New York City average. The borough has the highest rate of adults with asthma of any borough in the last 12 months.
Staten Island also has a higher percentage of smokers, 16 percent, compared to the citywide average of 13 percent.
WHAT IS PARTICLE POLLUTION?
There are numerous types of air pollution, and while some are worse than others, none are worse than particle matter (PM) and fine particulate matter (PM2.5) created by dust, smog, soot or smoke.
Particulate matter is so harmful that the International Agency for Research on Cancer (IARG) classified particulate matter in air pollution as a human carcinogen in 2013. Additionally, the World Health Organization recently reclassified the particulate component in pollution as a cancer risk.
"I think the biggest thing is concentration and how much we're exposed to; every little bit has a long-term, significant effect," said Richmond University Medical Center (RUMC) pulmonologist Dr. Kieth Diaz.
An area with a high number of smokers putting increasingly large amounts of particle matter into the air increases lung-related health issues for non-smokers.
Particulates from cigarette smoke are incredibly small, travel long distances easily, and can stay in the air for a long period of time, making it easier for the particulates to travel deep into your lungs, as well as settle on clothes, pets, and in carpet, Dr. Diaz explained.
Can residents do anything to reduce their exposure to toxic chemicals?
"The biggest thing by far is not smoking," Dr. Lackey said.
Dr. Diaz said a High Efficiency Particle (HEPA) filter removes over 99 percent of particle and particulate matter from the air in your home before it has a chance to settle.
CIGARETTE SMOKERS DOWN WHILE E-CIG SMOKERS RISE
Approximately 15.9 percent on Staten Islanders, or 57,000 adults, were cigarette smokers as of 2016, according to the city Department of Health's (DOH) Community Health Survey. The borough has the highest average of the city.
"It's strange in that we all know a 90-year-old who has been smoking for 40 years and hasn't had a problem; it's a mix of genetics and environment. But what we do know is that the more you're exposed and the longer it is, the higher your chances of having a problem are. Taking yourself out of that environment will decrease your chances of repercussions," Diaz said.
While the reduction in local smokers is positive, the emergence of electronic cigarettes poses many known - and unknown - risks.
Children are picking up electronic cigarettes a higher rate than conventional cigarettes, which forced the Surgeon General to declare it a public health concern.
In New York State, youth e-cigarette use rates went from 11 percent in 2014 to 21 percent in 2016; adult use declined from seven percent in 2014 to six percent in 2016.
Because they haven't been around as long as cigarettes, it's too soon to fully understand the internal effects of an electronic cigarette, but externally they pose significant harm.
"Two studies have found formaldehyde, benzene and tobacco-specific nitrosamines (all carcinogens) coming from secondhand emissions," according to the American Lung Association. "The U.S. Surgeon General has concluded that e-cigarette aerosol is not harmless, and can contain harmful and potentially harmful chemicals, including nicotine."
REDUCING SMOKERS BY 2020
New York, at city and state levels, has been implementing laws aimed at continuing downward smoking trends, an effort to reduce the number of non-smokers who are exposed to second-hand smoke.
The city DOH, for example, raised the minimum base price for a pack of cigarettes to $13 in an effort to reduce the number of smokers in the city from more than 850,000 to 160,000 by 2020.
The New York City Housing Authority (NYCHA) has also gone smoke-free; smoking in or within 25 feet of NYCHA buildings is prohibited. The prohibition follows the new federal Housing and Urban Development (HUD) rule requiring public housing nationwide to be smoke-free by July 30, 2018.
On a grassroots level, organizations like Tobacco-Free Staten Island through the Jewish Community Center (JCC) have been working with private property owners to go smoke-free.
In the last year, nine properties on Staten Island have taken a smoke free pledge through the JCC, said Ashely Zanatta, community engagement specialist for the JCC. The JCC provides the building owners with education and guidance.
"The majority is overwhelmingly supportive of the change; their residents want to live in smoke free houses and this allows them to make that available for them," Zanatta said. "Clean air is not a luxury."
Prohibiting smoking reduces the risk of fires, lowers maintenance costs, and removes exposure to particles and carcinogens that impact residents who are mostly seniors and young children.
Removing the exposure reduces illness like chronic asthma and ear infections, she explained.
"We've known all of the side effects of smoking since 1964 when the Surgeon General said there was a direct link between smoking and lung cancer," she said.
Reality Check started at the JCC in 2001 and places advocacy in the hands on Staten Island's youth.
"It's a youth-led adult movement across different high schools and middle schools, allowing kids to speak to policy makers and advocate for themselves," explained Carissa Mazzeo, Reality Check Lead.
Mazzeo said the children are given a multitude of information and tools to educate themselves and their peers, and allows them to hold smoke-free educational events across the borough.
"The most effective method we have and most important thing that we can do is to advocate and promote policies that regulate these products to make them less acceptable and accessible to everybody, especially our youth," Mazzeo said.