To the Smoker Who Loves Someone Else,

This letter is not really about you. It is not about your smoking, or getting you to quit. It is about the heart of someone you love, the heart of the one or ones in your life who inhale your cigarette smoke. It is about why, if you really love them, you will never again light up where they must inhale your smoke. Not in the car, the house or even in another room with the lit end of your cigarette stuck up the vacuum cleaner hose, if you really love them.

You may have thought the reasons for not smoking around them did not apply to you and yours. Yes, secondhand smoke kills more than 50,000 Americans every year, but those are other Americans. Yes, secondhand smoke increases the risk of heart disease by 30 percent in those who are exposed to it, but those were other hearts. Yes, it is a major cause of SIDS (sudden infant death sydrnom), lung cancer, asthma and other ailments in those who get their smoke second hand, but…

No more buts. As you smoke, your secondhand smoke is affecting the heart that loves you back, before you are even done smoking that last puff. New evidence suggests secondhand cigarette smoke immediately harms the lining in the blood vessels of the hearts of those who inhale that smoke. They don’t feel it happening, you cannot see it happening, but as you smoke, their heart arteries are being affected. In the dark, warm passages of blood around the heart, it is really that cold and simple.

The data comes from a new study in the Journal of the American Medical Association, “Acute Effects of Passive Smoking on the Coronary Circulation in Healthy Young Adults.” The study does not talk about your lover’s heart arteries, or his or her endothelium, but that is who the study really was about. It talks a lot about “endothelium,” the delicate lining of the arteries in the body. The endothelium is affected by secondhand smoke in a way that actually reduces blood flow to heart muscles while the smoke chemicals circulate in the blood. That is the mechanism thought to ultimately cause blockages in heart arteries, blockages that lead to heart attacks. No one knows which of the 4,000-plus chemicals in the smoke that the nonsmoker passively inhales causes the effect on the endothelium, but at least one of those bad boys does.

The JAMA study is the latest and most “personal” of many studies linking secondhand cigarette smoke to disease in the nonsmokers who inhale it from others. While its subjects were healthy, young, nonsmoking adults, it is likely that the endothelium of the arteries in children is also affected by second hand smoke. Other studies have shown that the blood vessels to the lungs of children are affected by secondhand smoke, as are the bronchi. These effects help explain the ravages of secondhand smoke on the lungs of children.

You might think this is just a cruel way to get you to quit, but it really is no such thing. In fact, I think I know how hard it might be to do that. I take the things that I love doing the most in life and imagine giving them up, cold turkey; kicking the smoking habit is probably even harder. I know that if it was easy, you would have done it, and that nothing speaks more to the power of your addiction to nicotine than the fact that you still smoke around us.

So I am not asking you to quit, just to take it outside the house, outside the car, outside the apartment, away from the hearts of the ones you love. (Smoking in another room is not enough.) If you take it outside you can give up all of those tricks you have tried inside to keep the smoke away from the rest of the household, like blowing it up the chimney.

On a winter day outside you may be colder but you will look a lot less dumb than you do with your head up the chimney. We can even set up the recliner and run the TV out there on an extension cord; watching The Weather Channel outside might be a real kick. If you need motivation to smoke outside, just remember the word ENDOTHELIUM, or feel the beat of their hearts against yours. You love them too much to be hurting their hearts as you smoke, and they need healthy hearts to love you back for a long time.

Erik N. Steele, D.O. is the administrator for emergency services at Eastern Maine Medical Center and is on the staff for emergency department coverage at six hospitals in the Bangor Daily News coverage area.