Amish give evidence of the dangers of tobacco

Study offers a clearer picture of the health impact of secondhand smoke

In bucolic Lancaster County, Pa., the Amish grow their own tobacco. In keeping with traditional gender roles, the men smoke the tobacco in cigars, pipes or cigarettes, while the women largely tend to abstain.

A recent study of the Old Order Amish community by University of Maryland researchers has nonetheless found the women to be just as susceptible to the health problems related to exposure to secondhand smoke.

It turned out that the male smokers were potentially harming the women by smoking.

The study by Robert M. Reed, a University of Maryland associate professor of medicine, found that exposure to even low amounts of secondhand smoke impaired the lung function of Amish family members, particularly the nonsmoking women, in a small but measurable way.

Reed said Amish men typically gather on Sundays to smoke, so he wasn’t sure he would find anything noteworthy because the amount of secondhand smoke Amish families were exposed to was likely very low.

“It was surprising that we found anything at all, and I think that this really tells us how detrimental secondhand smoke can be,” said Reed, who is also a pulmonary and critical care specialist at University of Maryland Medical Center. “I think there are some open questions of the certainty to which we can say that secondhand smoke exposure causes some things like obesity or diabetes, or a lower lung function. And I think our study tips the scale to make it more clear that those are also some of the ill effects.”

The study was published in the medical journal PLOS ONE in March.

The researchers examined data on a cross-section of 3,568 Amish who participated in three community surveys of cardiovascular health between 2001 and 2015, according to the University of Maryland Medical System. The data included tobacco use and secondhand smoke exposure from family members.

Because the researchers had records of familial relations in the community, they were able to determine which people had a father, brother or husband who smoked and thus conclude who might have been exposed to secondhand smoke. The researchers also tested lung function and took blood samples.

The researchers did not have to account for potential smoke exposure in the womb since women in the Amish community generally do not smoke. About a third of Amish men in the study smoked, with 64 percent smoking cigars, 46 percent smoking cigarettes and 21 percent smoking pipes. Reed said cigar and pipes produce more noxious secondhand smoke than cigarettes.

Reed said the team used liaisons who work with the Amish community. Other medical researchers have studied the Amish because their lifestyles allow for scientists to control for fewer variables.

“There have been a lot of studies on the effects of secondhand smoking,” Reed said. “But a lot of those studies have been kind of difficult to tease out what’s a true affect of the smoking and what may be related to other factors that are associated with the behavior of smoking,” such as socioeconomic status.

The Amish, he said, are more physically active than the average American, they eat more fruits and vegetables, they largely live in rural areas, and they generally have a similar diet.

Reed found that women who were exposed to secondhand smoke had a higher body mass index on average. Their LDL or “bad” cholesterol was higher, while their HDL or “good” cholesterol was lower. Their fasting glucose levels, an indicator of