second hand smoke essay

Secondhand Smoke and Cancer

What is secondhand smoke.

Secondhand smoke (sometimes called passive smoke, environmental tobacco smoke, or involuntary smoke) is a mixture of sidestream smoke (the smoke from the burning tip of a cigarette or other smoked tobacco product) and mainstream smoke (smoke exhaled by a smoker that is diluted by the surrounding air) ( 1 – 3 ).

Major settings of exposure to secondhand smoke include workplaces, public places such as bars, restaurants and recreational settings, and homes ( 4 ). Workplaces and homes are especially important sources of exposure because of the length of time people spend in these settings. The home is a particularly important source of exposure for infants and young children. Children and nonsmoking adults can also be exposed to secondhand smoke in vehicles, where levels of exposure can be high. Exposure levels can also be high in enclosed public places where smoking is allowed, such as restaurants, bars, and casinos, resulting in substantial exposures for both workers and patrons ( 3 ).

In the United States, most secondhand smoke comes from cigarettes, followed by pipes, cigars, and other smoked tobacco products.

How is secondhand smoke exposure measured?

Secondhand smoke exposure can be measured by testing indoor air for respirable (breathable) suspended particles (particles small enough to reach the lower airways of the human lung) or individual chemicals such as nicotine or other harmful and potentially harmful constituents of tobacco smoke ( 3 , 5 ).

Exposure to secondhand smoke can also be evaluated by measuring the level of biomarkers such as cotinine (a byproduct of nicotine metabolism ) in a nonsmoker’s blood, saliva, or urine ( 1 ). Nicotine, cotinine, and other chemicals present in secondhand smoke have been found in the body fluids of nonsmokers exposed to secondhand smoke.

Does secondhand smoke contain harmful chemicals?

Yes. Many of the harmful chemicals that are in the smoke inhaled by smokers are also found in secondhand smoke ( 1 , 3 , 6 , 7 ), including some that cause cancer ( 1 , 3 , 7 , 8 ).

These include:

• Tobacco-specific nitrosamines
• Benzo[ α ]pyrene
• 1,3–butadiene (a hazardous gas)
• Cadmium (a toxic metal)
• Formaldehyde
• Acetaldehyde

Many factors affect which chemicals and how much of them are found in secondhand smoke. These factors include the type of tobacco used in manufacturing a specific product, the chemicals (including flavorings such as menthol ) added to the tobacco, the way the tobacco product is smoked, and—for cigarettes, cigars, little cigars, and cigarillos—the material in which the tobacco is wrapped ( 1 – 3 , 7 ).

Does secondhand smoke cause cancer?

Yes. The U.S. Environmental Protection Agency, the U.S. National Toxicology Program, the U.S. Surgeon General , and the International Agency for Research on Cancer have all classified secondhand smoke as a known human carcinogen (a cancer-causing agent) ( 1 , 3 , 7 , 9 ). In addition, the National Institute for Occupational Safety and Health (NIOSH) has concluded that secondhand smoke is an occupational carcinogen ( 3 ).

The Surgeon General estimates that, during 2005-2009, secondhand smoke exposure caused more than 7,300 lung cancer deaths among adult nonsmokers each year ( 10 ). 

Some research also suggests that secondhand smoke may increase the risk of breast cancer, nasal sinus cavity cancer, and nasopharyngeal cancer in adults ( 10 ) and the risk of leukemia , lymphoma , and brain tumors in children ( 3 ). Additional research is needed to determine whether a link exists between secondhand smoke exposure and these cancers.

What are the other health effects of exposure to secondhand smoke?

Secondhand smoke is associated with disease and premature death in nonsmoking adults and children ( 3 , 7 ). Exposure to secondhand smoke irritates the airways and has immediate harmful effects on a person’s heart and blood vessels . It increases the risk of heart disease by about 25 to 30% ( 3 ). In the United States, secondhand smoke is estimated to cause nearly 34,000 heart disease deaths each year ( 10 ). Exposure to secondhand smoke also increases the risk of stroke by 20 to 30% ( 10 ).

Secondhand smoke exposure during pregnancy has been found to cause reduced fertility , pregnancy complications, and poor birth outcomes, including impaired lung development, low birth weight , and preterm delivery ( 11 ).

Children exposed to secondhand smoke are at increased risk of sudden infant death syndrome , ear infections , colds, pneumonia , bronchitis , and more severe asthma . Being exposed to secondhand smoke slows the growth of children’s lungs and can cause them to cough, wheeze, and feel breathless ( 3 , 7 , 10 ).

There is no safe level of exposure to secondhand smoke. Even low levels of secondhand smoke can be harmful.

How can you protect yourself and your family from secondhand smoke?

The only way to fully protect nonsmokers from secondhand smoke is to eliminate smoking in indoor workplaces and public places and by creating smokefree policies for personal spaces, including multiunit residential housing. Opening windows, using fans and ventilation systems, and restricting smoking to certain rooms in the home or to certain times of the day does not eliminate exposure to secondhand smoke ( 3 , 4 ).

Steps you can take to protect yourself and your family include:

• not allowing smoking in your home
• not allowing anyone to smoke in your car, even with the windows down
• making sure the places where your children are cared for are tobacco free
• teaching children to avoid secondhand smoke
• seeking out restaurants, bars, and other places that are smokefree (if your state still allows smoking in public areas)
• protecting your family from secondhand smoke and being a good role model by not smoking or using any other type of tobacco product. For help to quit see smokefree.gov or call 1-877-44U-QUIT.

Do electronic cigarettes emit secondhand smoke?

Electronic cigarettes (also called e-cigarettes, vape pens, vapes, and pod mods) are battery-powered devices designed to heat a liquid, which typically contains nicotine , into an aerosol for inhalation by a user. Following inhalation, the user exhales the aerosol ( 12 ).

The use of electronic cigarettes results in exposure to secondhand aerosols (rather than secondhand smoke). Secondhand aerosols contain harmful and potentially harmful substances, including nicotine, heavy metals like lead, volatile organic compounds, and cancer-causing agents. More information about these devices is available on CDC’s Electronic Cigarettes page.

What is being done to reduce nonsmokers’ exposure to secondhand smoke?

On the federal level, several policies restricting smoking in public places have been implemented. Federal law prohibits smoking on airline flights, interstate buses, and most trains. Smoking is also prohibited in most federal buildings by Executive Order 13058 of 1997 . The Pro-Children Act of 1994 prohibits smoking in facilities that routinely provide federally funded services to children. The Department of Housing and Urban Development published a final rule in December 2016, which was fully implemented in July 2018, that prohibits the use of cigarettes , cigars , pipes , and hookah (waterpipes) in public housing authorities, including all living units, indoor common areas, and administrative offices, as well as outdoor areas within 25 feet of buildings.

Many state and local governments have enacted laws that prohibit smoking in workplaces and public places, including restaurants, bars, schools, hospitals, airports, bus terminals, parks, and beaches. These smokefree policies have substantially decreased exposure to secondhand smoke in many U.S. workplaces ( 13 ). More than half of all states have implemented comprehensive smokefree laws that prohibit smoking in indoor areas of workplaces, restaurants, and bars, and some states and communities also have enacted laws regulating smoking in multi-unit housing and cars ( 14 ). The American Nonsmokers' Rights Foundation provides a list of state and local smokefree air policies .

To highlight the health risks from secondhand smoke, the National Cancer Institute requires that meetings and conferences organized or primarily sponsored by NCI be held in a state, county, city, or town that has adopted a comprehensive smokefree policy, unless specific circumstances justify an exception to this policy. 

Healthy People 2020 , a comprehensive nationwide health promotion and disease prevention framework established by the U.S. Department of Health and Human Services (HHS), includes several objectives addressing the goal of reducing illness, disability, and death caused by tobacco use and secondhand smoke exposure. For 2020, the Healthy People goal is to reduce the proportion of nonsmokers exposed to secondhand smoke by 10%. To assist with achieving this goal, Healthy People 2020 includes ideas for community interventions, such as encouraging the introduction of smokefree policies in all workplaces and other public gathering places, such as public parks, sporting arenas, and beaches.

Because of these policies and other actions, the percentage of nonsmokers who are exposed to secondhand smoke declined from 52.5% during 1999–2000 to 25.3% during 2011–2014 ( 15 ). Exposure to secondhand smoke declined among all population subgroups, but disparities still exist. During 2011–2014, 38% of children ages 3–11 years, 50% of non-Hispanic blacks, 48% of people living below the poverty level, and 39% of people living in rental housing were exposed to secondhand smoke ( 15 ).

New blog: Release of the 3rd Cigarette Tax Scorecard. Read more.

New blog: release of the 3rd cigarette tax scorecard., secondhand smoke.

There is no safe level of exposure to secondhand smoke (SHS) from combustible tobacco products. It can cause severe and fatal diseases, including cancer, cardiovascular disease, respiratory infections, and adverse reproductive effects. Children exposed to SHS are among the most vulnerable health-wise and the least able to protect themselves. Governments must enact measures to eliminate exposures to SHS in public and workplaces and homes.

• Last updated:  October 26, 2023

Exposure to secondhand tobacco smoke (SHS) was one of the leading risk factors for deaths globally in 2019, accounting for approximately 1.3 million deaths and contributing to 37 million Disability-Adjusted life years (DALYs), with 11.2% of the burden in children under the age of 5 years.

Secondhand smoke (SHS) includes the smoke from the burning end of a cigarette or other smoked tobacco products such as pipes, cigars, etc., and the smoke exhaled by the smoker. It is also referred to as passive smoking, environmental tobacco smoke, and tobacco smoke pollution.

SHS contains more than 7,000 chemicals, including irritants, systemic toxicants, mutagens, carcinogens, and reproductive and development toxicants. More than 70 of these compounds are carcinogens, which has led the US Environmental Protection Agency and the International Agency for Research on Cancer to classify SHS as a group A and group 1 carcinogen, respectively, indicating the most hazardous cancer-causing compounds.

It is widely recognized through scientific evidence that there is no safe level of exposure to SHS. It remains in the air for hours after smoked tobacco has been extinguished and can cause or contribute to various adverse health effects in adults and children, even if exposed for a short time.

Exposure to secondhand smoke can lead to lung cancer, acute and chronic coronary heart disease (CHD), and eye and nasal irritation in adults. Research also shows that the risks for CHD from passive smoking are essentially indistinguishable from active smoking. Children can suffer from asthma exacerbation, bronchitis and pneumonia, chronic middle ear infection, and chronic respiratory symptoms. Pregnant women exposed to SHS are more likely to experience stillbirths and have newborns with congenital malformations and lower birth weights; infants are at a significantly higher risk of sudden infant death syndrome (SIDS).

The World Health Organization (WHO) Report on the Global Tobacco Epidemic 2023 (RGTE) presents smoke-free legislation information for 195 countries and as of 2022, 2.1 billion people in 74 countries are covered by complete smoke-free indoor public places, workplaces, and public transport. These 74 countries include 21 high-income countries, 45 middle income countries, and 8 low-income countries. While these 74 countries (38%) show best practice levels in comprehensive smoke-free bans, there are still 35% of countries, with partial smoke-free ban environments. The remaining 53 countries (27%) fail to comprehensively protect people from secondhand smoke by having complete absence of or minimal smoking bans. Results from the Global Youth Tobacco Survey (GYTS) conducted in 142 countries from 2010 to 2018 indicate that adolescents aged 12-16 years were widely exposed (on ≥1 day in the past 7 days) to SHS in any place (62.9%), at home (33.3%), and in public places (57.6%).

Evidence shows persistent disparities in secondhand smoke exposure by ethnicity, education, and income level. In the U.S., non-Hispanic Black Americans and families living below the poverty level or in multi-unit housing are more likely than other groups to be exposed to SHS. Typically, people with lower educational attainment are less knowledgeable about SHS exposure risks. Awareness is also generally lower in low-income countries compared to high-income countries.

The dangers from SHS also extend to the e-cigarette aerosols that users exhale, which contain harmful and potentially harmful substances, including nicotine, heavy metals, and carcinogens. Though more research on the harm profile of second aerosol is needed, it is clear that these aerosols should be included in comprehensive smoke-free legislation in the same way as secondhand smoke.

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Institute for Health Metrics and Evaluation. Secondhand smoke risk. See https://www.healthdata.org/results/gbd_summaries/2019/secondhand-smoke-level-3-risk

Smoke-free policy coverage :

WHO report on the global tobacco epidemic, 2023: protect people from tobacco smoke. Geneva: World Health Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO.

Youth smoking :

Global Youth Tobacco Surveys (various years). See https://www.who.int/teams/noncommunicable-diseases/surveillance/systems-tools/global-youth-tobacco-survey .

Ma, C., Heiland, E. G., Li, Z., Zhao, M., Liang, Y., & Xi, B. (2021). Global trends in the prevalence of secondhand smoke exposure among adolescents aged 12–16 years from 1999 to 2018: an analysis of repeated cross-sectional surveys. The Lancet Global Health, 9(12), e1667-e1678.

Tobacco smoke as a carcinogen:

International Agency for Research on Cancer (IARC). Smoke, Tobacco, and Involuntary Smoking. In IARC monographs on the evaluation of carcinogenic risks to humans.  IARC, Lyon  1 (2004): 1-1452. https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Tobacco-Smoke-And-Involuntary-Smoking-2004

US Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders” (EPA 600/6/90/006F) (December 1992).

Exposure to SHS by discrete groups :

Homa DM, Neff LJ, King BA, Caraballo RS, Bunnell RE, Babb SD, Garrett BE, Sosnoff CS, Wang L. Vital signs: disparities in nonsmokers’ exposure to secondhand smoke—United States, 1999–2012. Morbidity and Mortality Weekly Report. 2015 Feb 2;64(4):103.

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What is secondhand smoke?

Why is secondhand smoke a problem, where is secondhand smoke a problem, what can be done about secondhand smoke, are lingering smoking odors harmful, is exposure to secondhand e-cigarette aerosol harmful.

Secondhand smoke (SHS) is also called environmental tobacco smoke (ETS). It’s a mixture of 2 forms of smoke that come from burning tobacco:

• Mainstream smoke: The smoke exhaled by a person who smokes.
• Sidestream smoke: Smoke from the lighted end of a cigarette, pipe, or cigar, or tobacco burning in a hookah. This type of smoke has higher concentrations of nicotine and cancer-causing agents (carcinogens) than mainstream smoke.

When people who don't smoke are exposed to SHS it’s called involuntary smoking or passive smoking . When you breathe in SHS, you take in nicotine and toxic chemicals the same way people who smoke do. The more SHS you breathe, the higher the levels of these harmful chemicals in your body.

Secondhand smoke (SHS) has the same harmful chemicals that people who smoke inhale. There’s no safe level of exposure for secondhand smoke (SHS).

Secondhand smoke causes cancer

Secondhand smoke is known to cause cancer. It has more than 7,000 chemicals, including about 70 that can cause cancer.

SHS causes lung cancer , even in people who have never smoked. There’s also some evidence suggesting it might be linked in adults to cancers of the:

• Larynx (voice box)
• Nasopharynx (the part of the throat behind the nose)
• Nasal sinuses

Exposure of mothers and babies to SHS is possibly linked to certain childhood cancers:

• Brain tumors

Secondhand smoke causes other diseases and death

Secondhand smoke can also be harmful in other ways. For instance, breathing secondhand smoke affects the heart and blood vessels, which increases the risk of having a heart attack. Exposure to secondhand smoke increases the risk of developing and dying from heart disease. It also increases the risk of having (and dying from) a stroke.

Secondhand smoke and your children’s health

Young children are most affected by SHS and least able to avoid it. Most of their exposure to SHS comes from adults (parents or others) smoking at home. Studies show that children whose parents smoke:

• Get sick more often
• Have more lung infections (like bronchitis and pneumonia)
• Are more likely to cough, wheeze, and have shortness of breath
• Get more ear infections

Secondhand smoke can also trigger asthma attacks or make asthma symptoms worse.

Some of these problems might seem small, but they can add up quickly. Think of the expenses, doctor visits, medicines, lost school time, and often lost work time for the parent who must stay home with a sick child. And this doesn’t include the discomforts that the child goes through.

In very young children, SHS also increases the risk for more serious problems, including sudden infant death syndrome (SIDS).

You should be especially concerned about exposure to secondhand smoke (SHS) in these places:

The workplace is a major source of SHS exposure for many adults.

The Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH), federal agencies responsible for health and safety in the workplace, recognize there are no known safe levels of SHS and recommend that exposures be reduced to the lowest possible levels.

The Surgeon General has said that smoke-free workplace policies are the only way to prevent SHS exposure at work. Separating people who smoke from those who don't, cleaning the air, and ventilating the building cannot prevent exposure if people still smoke inside the building. An extra bonus of workplace smoking restrictions, other than protecting those who don't smoke, is that they may also encourage people who do to smoke less, or even quit.

In public places

Everyone can be exposed to SHS in public places where smoking is allowed, such as some restaurants, shopping centers, public transportation, parks, and schools. The Surgeon General has suggested people choose smoke-free restaurants and businesses, and let owners of businesses that are not smoke-free know that SHS is harmful to your family’s health.

Public places where children go are a special area of concern. Make sure that your children’s daycare centers and schools are smoke-free.

Some businesses might be afraid to ban smoking, but there’s no strong evidence that going smoke-free is bad for business.

Making your home smoke-free may be one of the most important things you can do for the health of your family. Any family member can develop health problems related to SHS. Children’s growing bodies are especially sensitive to the toxins in SHS. And think about it: we spend more time at home than anywhere else. A smoke-free home protects your family, your guests, and even your pets.

Multi-unit housing where smoking is allowed is a special concern and a subject of research. Tobacco smoke can move through air ducts, wall and floor cracks, elevator shafts, and along crawl spaces to contaminate units on other floors, even those that are far from the smoke. SHS cannot be controlled with ventilation, air cleaning, or by separating those who smoke from those who don't.

Americans spend a great deal of time in cars, and if someone smokes there, the toxins can build up quickly – even when the windows are open or the air-conditioner is on. Again, this can be especially harmful to children.

In response to this fact, many expert medical groups have been working to encourage people to make their cars, as well as their homes, smoke-free. Some states and cities even have laws that ban smoking in the car if carrying passengers under a certain age or weight. And many facilities such as city buildings, malls, schools, colleges, and hospitals ban smoking on their grounds, including their parking lots.

There is no safe level of exposure to secondhand smoke (SHS). Any exposure is harmful.

The only way to fully protect people who don't smoke from SHS indoors is to prohibit all smoking in that indoor space or building. Separating those who smoke from those who don't, cleaning the air, and ventilating buildings cannot keep people who don't smoke from being exposed to SHS.

Many US local and state governments, and even federal governments in some other countries, have decided that protecting the health of employees and others in public places is of the utmost importance and have passed clean indoor air laws. Although the laws vary from place to place, they are becoming more common. Detailed information on smoking restrictions in each state is available from the American Lung Association .

You don’t have to wait for the government to act. Even if you smoke, you can decide to make your home and car smoke-free. This is the safest thing to do for your children, other family members, pets, and guests.

There’s very little research so far on whether lingering tobacco smoke odors or residuals from it on surfaces can cause cancer in people. Research does show that particles from secondhand tobacco smoke can settle in dust and on surfaces and remain there long after the smoke is gone. Some studies suggest the particles can last for months. Even though it’s no longer in the form of smoke, researchers often call this thirdhand smoke (THS) or residual tobacco smoke .

Particles that settle out from tobacco smoke have been shown to combine with gases in the air to form cancer-causing compounds that settle onto surfaces. For instance, some of the carcinogens that are known to cause lung cancer have been found in dust samples taken from the homes of people who smoke. Research has also shown that thirdhand smoke can damage human DNA in cell cultures and might increase lung cancer risk in lab animals.

Though it’s not yet clear if such smoke residue can cause cancer, any effects would probably be small compared with direct exposure to SHS. Still, the compounds may be stirred up and inhaled with other house dust, and may also be accidentally taken in through the mouth. Because of this, any risk the compounds pose is probably greater for babies and children who play on the floor and often put things in their mouths.

The health risks of THS are an active area of research.

As e-cigarettes and similar devices have become more popular in recent years, a growing concern is whether the aerosol of tiny particles exhaled by users, sometimes referred to as secondhand vapor , is harmful to other people who breathe it in.

Scientists are still learning about the health effects of being exposed to secondhand e-cigarette aerosol. However, the US Surgeon General has concluded that e-cigarette aerosol is not harmless. Secondhand aerosol can expose others to nicotine, and possibly to other harmful chemicals.

Smoke-free and tobacco-free policies already in place should also cover e-cigarettes. This will help non-users avoid being exposed to potentially harmful e-cigarette aerosol.

To learn more about e-cigarettes and similar devices, see What Do We Know About E-cigarettes?

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

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US Environmental Protection Agency. Secondhand Tobacco Smoke and Smoke-free Homes. 2020. Accessed at www2.epa.gov/indoor-air-quality-iaq/secondhand-tobacco-smoke-and-smoke-free-homes on October 15, 2020.

Last Revised: January 12, 2023

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Health Effects of Secondhand Smoke

Secondhand smoke is a serious health hazard causing more than 41,000 deaths per year. It can cause or make worse a wide range of damaging health effects in children and adults, including lung cancer, respiratory infections and asthma.

The American Lung Association has more information available on laws protecting the public from exposure to secondhand smoke.

Key Facts about Secondhand Smoke

• Secondhand smoke causes approximately 7,330 deaths from lung cancer and 33,950 deaths from heart disease each year. 1
• Between 1964 and 2014, 2.5 million people died from exposure to secondhand smoke, according to the 2014 report from the U.S. Surgeon General. The report also concluded that secondhand smoke is a definitive cause of stroke. 1
• There is no risk-free level of exposure to secondhand smoke and even short-term exposure potentially can increase the risk of heart attacks. 2
• Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide. 2
• Secondhand smoke can cause heart attacks; even relatively brief exposure can trigger a heart attack, according to a report by the Institute of Medicine. 3

Secondhand Smoke in the Workplace

• Secondhand smoke costs our economy $5.6 billion per year due to lost productivity. 1
• The health of nonsmokers exposed to secondhand smoke at work is at increased risk. Levels of secondhand smoke in restaurants and bars were found to be 2-5 times higher than in residences with smokers, and  2-6 times higher than in office workplaces. 4
• Being employed in a workplace where smoking is prohibited is associated with a reduction in the number of cigarettes smoked per day and an increase in the success rate of smokers who are attempting to quit. 5
• Casino workers in particular are exposed to hazardous levels of toxic secondhand smoke at work, including tobacco-specific carcinogens that increased in their bodies as their work shifts progressed, according to a report from the National Institute for Occupational Safety and Health. 6

Secondhand Smoke and Children

• Secondhand smoke is especially harmful to young children. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year. It also causes 430 sudden infant death syndrome (SIDS) deaths in the U.S. annually. 7
• Secondhand smoke exposure may cause a buildup of fluid in the middle ear, resulting in 790,000 doctor's office visits per year, as well as more than 202,000 asthma flare-ups among children each year. 7
• More than 23 million, or about 35% of children in the U.S. have been exposed to secondhand smoke. 8

Secondhand Smoke and Lung Cancer Patients

• Reduced overall survival.
• Reduced progression-free survival (the length of time during and after treatment when the cancer does not grow or spread).
• Simply put: lung cancer patients exposed to secondhand smoke are more likely to die than patients not exposed.
• Exposure to secondhand smoke makes it harder for lung cancer patients who smoke to quit smoking. 10 Smoking during lung cancer treatment makes the treatment less effective. 11,12

What about Thirdhand Smoke?

Learn about the American Lung Association's programs  to help you or a loved one quit smoking , and join our advocacy efforts to reduce tobacco use and exposure to secondhand smoke. Visit Lung.org or call the Lung HelpLine at 1-800-LUNGUSA (1-800-586-4872).

What is Secondhand Aerosol from E-Cigarettes?

What is secondhand smoke, what is thirdhand smoke.

U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. 2014.

U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. 2006.

Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington, DC: The National Academies Press. 2009.

U.S. Department of Health and Human Services. Report on Carcinogens, Tenth Edition 2002. National Toxicology Program.

National Cancer Institute. Population Based Smoking Cessation: Proceedings of a Conference on What Works to Influence Cessation in the General Population, Smoking and Tobacco Control Monograph 12. NIH Pub. 00-4892, Nov. 2000.

National Institute for Occupational Health and Safety. Environmental and Biological Assessment of Environmental Tobacco Smoke among Casino Dealers, May 2009.

California Environmental Protection Agency. Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Executive Summary. June 2005.

Centers for Disease Control and Prevention. Exposure to Secondhand Smoke Among Nonsmokers — United States, 1988-2014. Morbidity and Mortality Weekly Report. December 7, 2018; 67(48):1342-6.

Zhou W, Heist RS, Liu G, et al. Secondhand smoke exposure and survival in early-stage non-small cell lung cancer patients. Clin Cancer Res 2006;12:7187–93.

Eng, et al. Second-Hand Smoke As a Predictor of Smoking Cessation Among Lung Cancer Survivors. 2014, doi: 10.1200/JCO.2013.50.9695

Gemine R and Lewis K. Smoking Cessation with Lung Cancer: Not Too Little, Never Too Late! EMJ Respir. 2016;4[1]:86-91.

Parsons A, et al. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ 2010;340:b5569. doi:10.1136/bmj.b5569

Page last updated: June 25, 2024

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Health Problems Caused by Secondhand Smoke

• There is no safe level of exposure to secondhand smoke.
• People who do not smoke but who are exposed to secondhand smoke, even for a short time, can suffer harmful health effects.
• There is no safe level of exposure to secondhand smoke (SHS); even brief exposure can cause immediate harm. 1 2 3
• Health problems caused by secondhand smoke in adults who do not smoke include coronary heart disease, stroke, and lung cancer, as well as adverse reproductive health effects in women, including low birth weight. 1 3
• Secondhand smoke can cause sudden infant death syndrome (SIDS), respiratory infections, ear infections, and asthma attacks in infants and children. 1

What are the health problems caused by secondhand smoke?

The effects of secondhand smoke exposure on the body are immediate. 1 3 Since 1964, about 2,500,000 people who did not smoke died from health problems caused by secondhand smoke exposure. 1

• In adults who do not smoke, secondhand smoke exposure can cause coronary heart disease, stroke, lung cancer, and other diseases. It can also result in premature death. 1 2 3
• Secondhand smoke can cause adverse reproductive health effects in women, including low birth weight. 1 3
• In children, secondhand smoke exposure can cause respiratory infections, ear infections, and asthma attacks. In babies, secondhand smoke can cause sudden infant death syndrome (SIDS). 1 2 3
• Secondhand smoke exposure can produce harmful inflammatory and respiratory effects within 60 minutes of exposure which can last for at least three hours after exposure. 4

Secondhand smoke causes heart disease and stroke

For adults who do not smoke, exposure to secondhand smoke has immediate harmful effects on the heart and blood vessels and can cause coronary heart disease and stroke. 1 3 5

• Among adults who do not smoke, secondhand smoke causes nearly 34,000 premature deaths from heart disease each year in the U.S. 1
• Adults who do not smoke and are exposed to secondhand smoke increase their risk of developing coronary heart disease by 25–30%. 1
• Adults who do not smoke and are exposed to secondhand smoke increase their risk of stroke by 20−30%. 1
• Exposure to secondhand smoke interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of having a heart attack. 1 2 3
• Even brief exposure to secondhand smoke can damage the lining of blood vessels and cause blood platelets to become stickier. These changes can cause an increased risk of heart attack. 1 2 3
• People who already have heart disease are at especially high risk of suffering the harmful effects from breathing secondhand smoke. They should take special precautions to avoid even brief exposures. 1

Secondhand smoke causes lung cancer

• Adults who do not smoke and are exposed to secondhand smoke increase their risk of developing lung cancer by 20–30%. 1 3
• Secondhand smoke causes more than 7,300 lung cancer deaths each year among U.S. adults who do not smoke. 1 3
• People who do not smoke but are exposed to secondhand smoke are inhaling many of the same cancer-causing substances and poisons that are inhaled by people who smoke. 1 2 3
• Even brief exposure to secondhand smoke can damage the body's cells in ways that set the cancer process in motion. 1
• As with active smoking, the longer the duration and the higher the level of exposure to secondhand smoke, the greater the risk of developing lung cancer. 1

Secondhand smoke causes reproductive health problems in pregnant people

• Women exposed to secondhand smoke during pregnancy are more likely to have newborns with lower birth weight, increasing the risk of health complications. 1 2

Secondhand smoke causes sudden infant death syndrome (SIDS)

• Infants exposed to secondhand smoke after birth are more likely to die from sudden infant death syndrome (SIDS) than infants who are not exposed to smoke from burning commercial tobacco products. 1 2 4 5 SIDS is the sudden, unexplained, unexpected death of an infant in the first year of life.
• SIDS is the leading cause of death in otherwise healthy infants. 6
• Smoking by women during pregnancy increases the risk for SIDS. 1 3 7
• Chemicals in secondhand smoke appear to affect the brain in ways that interfere with its regulation of infants' breathing. 1 3
• Infants who die from SIDS have higher concentrations of nicotine in their lungs and higher levels of cotinine (a biological marker for secondhand smoke exposure) than infants who die from other causes. 1 3

Secondhand smoke can trigger asthma attacks and cause other health problems in children

• Children who are exposed to secondhand smoke are at an increased risk for acute respiratory infections such as pneumonia and bronchitis, middle ear disease, more frequent and severe asthma, respiratory symptoms, and slowed lung growth. 1
• Wheezing, coughing, and shortness of breath are more common in children exposed to secondhand smoke. 3
• Children whose parents smoke around them get more ear infections. They also have fluid in their ears more often and have more operations to put in ear tubes for drainage. 3
• Secondhand smoke can trigger an asthma attack in a child. Children with asthma who are around secondhand smoke have more severe and frequent asthma attacks. A severe asthma attack can put a child's life in danger. 3
• U.S. Dept of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General . U.S. Dept of Health and Human Services; 2014.
• U.S. Dept of Health and Human Services. A Report of the Surgeon General: How Tobacco Smoke Causes Disease...What It Means to You . U.S. Dept of Health and Human Services; 2010.
• U.S. Dept of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General . U.S. Dept of Health and Human Services; 2006.
• Flouris AD, Koutedakis Y. Immediate and short-term consequences of secondhand smoke exposure on the respiratory system . Curr Opin Pulm Med . 2011;17(2):110–115.
• Institute of Medicine Committee on Secondhand Smoke Exposure and Acute Coronary Events. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence . National Academies Press; 2010.
• American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome. The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk . Pediatrics. 2005;116(5):1245–1255.
• U.S. Dept of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General . U.S. Dept of Health and Human Services; 2004.

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Research impact, columbia center for children's environmental health, secondhand smoke.

(Español) It has been well documented that exposure to secondhand smoke is extremely unhealthful. Secondhand smoke gets into the air when tobacco products are burned in cigarettes, cigars, and pipes. Secondhand smoke — also known as environmental tobacco smoke (ETS) — contains thousands of toxic chemicals, many of which are known to cause cancer. A U.S. Surgeon General report in 2006 stated that exposing nonsmokers to secondhand smoke at home or work significantly increases their risk of developing heart disease and lung cancer. Secondhand smoke also has adverse effects on children and can lead to respiratory problems, ear infections, and asthma attacks.

In 1964, the Surgeon General released its first major report on the devastating health effects of smoking. It was a turning point in the public health field, and since then research has supported a number of policy changes and initiatives to curtail smoking and minimize exposure to secondhand smoke. As part of the 2003 Clean Indoor Air Act, New York State banned smoking completely from bars, restaurants, schools, hotels, and all places of employment. Research on the health effects of secondhand smoke as well as its socioeconomic implications continues today.

What We Know About Secondhand Smoke

Research shows that exposure to even small levels of secondhand tobacco smoke is associated with the development of many serious health problems, including heart disease, cancer, chronic respiratory infections, and asthma. Exposure to secondhand smoke during pregnancy can harm a baby’s healthy growth and development for years to come.  Prenatal exposure  to tobacco smoke is associated with abnormal lung function in infancy that can persist through adolescence, as well as lower birth weights, premature delivery, Sudden Infant Death Syndrome (SIDS), and miscarriage.

Center research is showing that exposure to secondhand tobacco smoke may worsen health problems linked with exposure to  PAH  in air pollution as well as conditions of poverty:

Results from our Mothers and Newborns Studies suggest that the interaction of prenatal exposure to PAH and postnatal exposure to secondhand tobacco smoke leads to increased respiratory symptoms and a probable diagnosis of asthma by ages one and two years. Respiratory symptoms include cough, difficulty breathing, wheeze, and probable asthma ( Miller et al., 2004 ).

Children prenatally exposed to secondhand smoke — especially children experiencing material hardship (unmet basic needs such as food, clothing, and housing) — had significantly reduced scores on tests of cognitive development at two years of age ( Rauh et al., 2004 ).

What You Can Do

There are many things to do to minimize exposure to secondhand smoke:

Do not smoke. And don’t allow anyone else to smoke in your home or car where smoke gets contained and remains in carpets, clothing, and furniture.

If you, another household member, or guest must smoke, do it outdoors and away from children.

Choose your caregivers carefully. Make sure they do not smoke or, if they do, insist that they not to smoke around your child.

Encourage family members and close friends who smoke to quit.

Source: Adapted from www.kidshealth.org: “The Dangers of Secondhand Smoke”

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Awareness of health effects of exposure to secondhand smoke from cigarettes: A cross-sectional study of never-smoked adult primary care patients in Eastern Nigeria

Gabriel uche pascal iloh.

Department of Family Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria

Peace Ifeoma Collins

1 Department of Nutrition and Dietetics, Federal Medical Centre, Umuahia, Abia State, Nigeria

Background:

Cigarette smoking whether actively or passively is a growing public health problem. Despite the wealth of information on the hazards of active cigarette smoking, awareness of the health effects of passive smoking on human population is often neglected in Nigeria.

The study was aimed at describing the awareness of health effects of exposure to secondhand smoke from cigarettes among never-smoked adult primary care patients in Eastern Nigeria.

Materials and Methods:

A hospital-based study carried out on a cross-section of 500 adult patients in a primary care clinic in Nigeria. Data were collected using pretested, structured, and interviewer-administered questionnaire. Exposure to secondhand smoke was defined as exposure to cigarette smoke in a never-smoked adult patient in the previous 1 year. Data were analyzed using Statistical Package for Social Sciences version 21 for the calculation of percentages for categorical variables. Bivariate analysis involving Chi-square test was used to test for significance of association between categorical variables at P < 0.05.

The age of the respondents ranged from 18 to 74 years, with a mean age of 36 ± 12.4 years. There were 180 (36.0%) males with 320 (64%) females, with a sex ratio of 1.8. Awareness of general health effects of secondhand smoke on adults, children, and pregnant women was 95.6%, 92.8%, and 65.2%, respectively. The most common specific health effects the respondents were aware for adults, children, and obstetric population were lung cancer (95.6%), precipitation of asthmatic condition (92.8%), and delivery of small babies (65.2%), respectively. The predominant source of awareness of information was radio (93.6%). Awareness of general health effects of exposure to secondhand smoke on adults ( P = 0.041), children ( P = 0.031), and obstetrics population ( P = 0.02) was significantly associated with exposure status.

Conclusion:

The most common health effects of secondhand smoke the respondents had highest awareness were lung cancer, precipitation of asthmatic attacks, and delivery of small babies in adults, children, and obstetric population, respectively. Awareness of general health effects on adults, children, and obstetrics population was significantly associated with exposure status. The current level of awareness should be improved while effort should be intensified to address identified areas of low level of awareness.

INTRODUCTION

Active and passive smoking of cigarettes constitutes a significant cause of morbidity among global population and is one of the modifiable risk factors of preventable mortality.[ 1 , 2 , 3 ] Over the last decade, research studies on secondhand smoke and their health effects have been reported with high degree of convergence of research findings with stronger conclusion motivating the need to develop personal, family, and environmental protective policies.[ 4 , 5 , 6 ] However, research studies have established the fact that inhalation of secondhand smoke is not only hazardous but also harmful to the health,[ 1 , 2 , 6 , 7 , 8 ] with reported morbidity measured by disability-adjusted life years varying from one part of the world to the other.[ 1 , 6 ] The exposure to secondhand smoke has reportedly caused an estimated 5% of global burden of disease slightly higher than 4% from active tobacco smoking.[ 7 ]

The health effects of secondhand smoke have been reported among global population in Nigeria[ 9 , 10 ] and other parts of the world such as the United States of America,[ 11 , 12 ] India,[ 13 ] Italy,[ 14 ] and Canada.[ 15 ] In adult population, secondhand smoke is associated with increased risk of tobacco-related disorders such as lung cancer[ 12 , 14 , 15 , 16 ] and stroke,[ 17 , 18 ] increases the risk of tuberculosis infection and progression to tuberculosis disease,[ 19 , 20 ] and can trigger an asthmatic condition.[ 15 , 16 ] Among the obstetric population, exposure of pregnant women to secondhand smoke has been reported to be associated with low birth weight[ 13 , 21 , 22 ] and preterm delivery.[ 23 ] Globally, exposure to secondhand smoke constitutes a major hazard to health of millions of children.[ 1 , 4 ] Children are therefore vulnerable population and have little choices about exposure to secondhand smoke which has been reported to precipitate asthmatic attack,[ 11 , 14 , 23 , 24 ] respiratory infections,[ 13 , 25 , 26 ] ear infections,[ 27 ] and sudden infant death syndrome.[ 28 ]

The clinical and public health consequences of secondhand smoke are enormous warranting the need for patient, family, and population health education on the dangers of passive smoking.[ 1 , 2 , 29 , 30 ] Despite the growing problem of cigarette smoking, awareness of the primary care patients on the health effects of secondhand smoke has not been reported among primary care patients in Nigeria. These patients are likely to be affected by health effects of exposure to secondhand smoke, resulting in frequency of visits to general outpatient clinic and referral to other specialty clinics. It is against this background that the researchers described the awareness of health effects of exposure to secondhand smoke from cigarettes among ambulatory never-smoked adult Nigerians in a primary care clinic of a tertiary hospital in Nigeria.

MATERIALS AND METHODS

This was a cross-sectional descriptive study carried out on 500 adult patients from August 2016 to September 2016 at the Department of Family Medicine of a tertiary hospital located in Umuahia, Southeast Nigeria.

Umuahia is the capital of Abia State, Southeast Nigeria. Abia State is endowed with abundant mineral and agricultural resources with supply of professional, skilled, semi-skilled, and unskilled personnel. Economic and social activities are low as compared to industrial and commercial cities such as Onitsha, Port Harcourt, and Lagos in Nigeria. Until recently, the Capital City and its environ have witnessed an upsurge in the number of banks, hotels, schools, markets, industries, junk food restaurants in addition to the changing dietary and social lifestyles. The Department of Family Medicine serves as a primary care clinic within the tertiary hospital setting of the medical center. All adult patients excluding those who need emergency health-care services, pediatric patients, and antenatal women are first seen at the Department of Family Medicine where diagnoses are made. Patients who need primary care are managed and followed up in the clinic while those who need other specialists care are referred to the respective core specialist clinics for further management.

The inclusion criteria were patients aged 18 years and above and patients who had never-smoked cigarette in their lifetime. The exclusion criteria were critically ill patients, ex-smokers, and current smokers.

Sample size was estimated using the formula[ 31 ] for calculating minimum sample size for descriptive studies when the population is equal or more than 10,000; N = Z 2 pq / d 2 where N = minimum sample size, Z = standard normal deviation usually set at 1.96 which corresponds to 95% confidence interval, and P = proportion of the population estimated to have a particular characteristic. Due to the absence of similar study on awareness of exposure to secondhand smoke among primary care patients in Nigeria, the authors assumed that 50% of the adult patients would be aware of the health effects of secondhand smoke from cigarettes at 95% confidence level and 5% margin of error.[ 31 ] This assumption was likely to maximize the estimated variance and provided a sample size that was precisely representative for the study population. This gave a sample size estimate of 384; thus, q = 1.0 − P = 1.0 − 0.5 = 0.5, d = degree of accuracy set at 0.05. Hence, n = (1.96) 2 × 0.5 × 0.5/(0.05) 2 . Therefore, n = 384. A sample size of 500 patients was used for the study to improve the precision of the study.

The sampling method involved consecutive selection of every adult patient who registered to see the clinicians on each consulting day during the study period and who met the inclusion criteria until the sample size of 500 was achieved.

The study tool was designed by the researchers from Global Adult Tobacco Survey Global Tobacco Surveillance System,[ 32 , 33 ] National Human Activity Pattern Survey,[ 34 ] and robust review of literature on previous studies on awareness of health effects of exposure to secondhand smoke and active smoking.[ 10 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 34 , 35 , 36 , 37 ]

The questionnaire had sections on sociodemographic variables and awareness of general and specific health effects of exposure to secondhand smoke from cigarettes on adults, children, and obstetrics population. It consisted of dichotomous questions which were structured in such a way that could elicit immediate answers from the respondents in a yes or no format. The 17-item questions on awareness of health effects of exposure to secondhand smoke were interviewer administered due to limited health literacy of the study participants on medical lexicography to avoid incomplete information on the study tool. Three questions were asked on general health effects. Six questions were asked on specific health effects of exposure to secondhand smoke on adults (lung cancer, bronchitis, heart attack, stroke, hypertension, and diabetes mellitus); four questions were asked on specific health effects of exposure to secondhand smoke on children (precipitation of asthmatic condition, precipitation of respiratory infections, precipitation of ear infections, and sudden infant death syndrome); and four questions were asked on specific health effects of exposure to secondhand smoke on obstetrics population (early delivery of baby before date, birth defects, delivery of small babies, and miscarriage). Awareness of health effects of exposure to secondhand smoke referred to positive response to questions on health effects of secondhand smoke.

The questionnaire tool was also pretested for reliability and operational feasibility using ten ever-smoked patients. The pretesting was done to find out how the questions would interact with the respondents and ensure that there were no ambiguities. However, no change was necessary after the pretesting as the questions were interpreted with the same meaning as intended.

Operationally, secondhand smoke referred to involuntary inhalation of smoke from burning cigarettes generated by another person. Exposure to secondhand smoke was defined as exposure to cigarette smoke in a never-smoked adult patient in the previous 1 year.

Ethical certification was obtained from the Health Research and Ethics Committee of the hospital. Informed consent was also obtained from the respondents included in the study.

The data generated were analyzed using software International Business Machines Corporation, Statistical Package for Social Sciences (IBM SPSS) version 21, New York, USA. Categorical variables were described by frequencies and percentages. Bivariate analysis involving Chi-square test was used to test for significance of association between categorical variables. The level of significance was set at P < 0.05.

The age of the respondents ranged from 18 to 74 years, with a mean age of 36 ± 12.4 years. There were 180 (36.0%) males and 320 (64%) females, with a male to female ratio of 1:1.8. Other demographic variables are shown in Table 1 .

Demographic variables of the study respondents ( n =500)

Of the 500 respondents who participated in the study, 478 (95.6%) were aware of the general health effects of exposure to secondhand smoke from cigarettes on adults, 464 (92.8%) were aware of the general health effects of exposure to secondhand smoke from cigarettes on children, while 326 (65.2%) were aware of the general health effects of exposure to secondhand smoke from cigarettes on obstetric population.

On distribution of the study participants based on the awareness of specific health effects of exposure to secondhand smoke on adults, children, and obstetric population, the most common health effects the respondents were aware for adults, children, and obstetric population were lung cancer (95.6%), precipitation of asthmatic condition (92.8%), and delivery of small babies (65.2%), respectively [ Table 2 ].

Distribution of the respondents based on awareness of specific health effects of secondhand smoke on adult, children, and obstetrics population, respectively

On the distribution of the respondents based on the source of awareness information on the general health effects of exposure to secondhand smoke from cigarettes, the most common source of information was radio adverts (93.6%). Others included health workers (72.4%) and friends (55.6%) among others [ Table 3 ].

Distribution of the respondents based on the source of awareness of information on the general health effects of secondhand smoke

On bivariate analysis of the awareness of general health effects of exposure to secondhand smoke on adults and the exposure status, the statistical association was statistically significant (χ 2 = 8.63; P = 0.041). Similarly, on the awareness of general health effects of exposure to secondhand smoke on children and the exposure status, the association was statistically significant (χ 2 = 14.05; P = 0.31) while the association between awareness of general health effects of exposure to secondhand smoke on obstetric population and the exposure status was statistically significant (χ 2 = 8.73; P = 0.020) [ Table 4 ].

Association between awareness of general health effects of exposure to secondhand smoke on adults, health effects on children, and health effects on obstetrics population and exposure status, respectively

The awareness of general health effects of secondhand smoke was highest for the health effects on adult population when compared with children and pregnant mothers. This finding could be a reflection of research priorities and antismoking messages in Nigeria which are skewed toward the awareness of health effects of active cigarette smoking with emphasis on adult health.[ 38 , 39 , 40 ] Although there is absence of research reports on the awareness of health effects of exposure to secondhand smoke on children and obstetric population in Nigeria, there is a plethora of research on the awareness of health effects of exposure to secondhand smoke on children[ 1 , 24 , 25 , 26 , 27 , 28 , 37 ] and obstetric population[ 1 , 21 , 22 , 23 , 37 , 40 ] in advanced nations with variable results reported. The findings of this study therefore present an opportunity to initiate neighbor-to-neighbor and mass media campaign on health effects of secondhand smoke on adults, children, and pregnant mothers. This will help increase the public knowledge on secondhand smoke-related illnesses and diseases. Health warnings on cigarette pack can also help reinforce the message about harm from secondhand smoke. Relevant stakeholders should intensify health education campaign which should remind smokers of their responsibility to protect never-smoked adults, children, and obstetric population from exposure to secondhand smoke.

The most common specific health effect the respondents identified for adult population was lung cancer with 95.6% of them been aware. The possible explanation of the comparatively highest level of awareness of lung cancer as the most common health effects of secondhand smoke on adults could be due to public information on dangers of active cigarette smoking on respiratory health in Nigeria.[ 38 , 39 ] Globally, the increase in the prevalence of lung cancer and other tobacco-related diseases has been associated with exposure to secondhand smoke.[ 1 , 14 , 15 , 16 , 37 , 41 ] Research studies have also shown that the risk of lung cancer in nonsmokers exposed to secondhand smoke is increased by 20%–30%.[ 24 , 41 ] Of great concern in the study area was that cigarette smokers have poor knowledge of the magnitude of harm and hazards of sidestream and mainstream smokes from burning cigarettes while innocent nonsmokers are not knowledgeable of the possible adverse long-term consequences of exposure to carcinogenic chemicals from secondhand smoke. The longer one inhales secondhand smoke from burning cigarettes, the greater the risk of developing lung cancer.

The most common specific health effect of exposure to secondhand smoke the respondents were aware was precipitation of asthmatic condition with 92.8% of them been aware. The relatively higher awareness of the health effects of secondhand smoke on pediatric population among the study population is a mirror of the societal disgust and attitude to smoking in the presence of children, which exposed them to passive inhalation of toxic chemicals from secondhand smoke. Research studies have shown that young children are most affected by secondhand smoke from adult parents and significant others who smoke in the presence of children with the most common respiratory health effects being precipitation of asthmatic condition.[ 1 , 24 , 36 , 37 ] According to these reports, children are particularly at higher risk of the health effects of secondhand smoke because their bodies are still growing and they breathe more rapidly with a higher relative ventilation rate, inhaling more pollutants from secondhand smoke per body weight than adults. In addition, unlike adult who can choose to avoid smoking environment, children have little choice over secondhand smoke and are least able to avoid it. Furthermore, children whose parents smoke are more likely to cough, have shortness of the breath, and can trigger asthmatic attack resulting in frequent hospital consultations and hospitalizations.[ 37 , 42 , 43 ] The implication is that smokers can help protect children from secondhand smoke and should not wait for enabling laws and policies. This will enable the smokers to recognize that secondhand smoke is dangerous to health of children and will spur them not to smoke in the presence of children.

The most common specific health effect the respondents identified for obstetric population was delivery of small babies with 65.2% of them been aware. The comparatively low awareness of obstetrics effects of toxic chemicals from secondhand smoke on pregnant women is similar to reports from Riyadh, Saudi Arabia,[ 35 ] and Peoples Republic of China.[ 44 ] Research studies have demonstrated the health risk associated with exposure to secondhand smoke in pregnant women with babies born to mothers exposed to secondhand smoke being at higher risk of low birth weight among other abnormalities.[ 1 , 21 , 22 , 35 , 37 , 44 ] Although there is poverty of research reports on health effects of exposure to secondhand smoke on pregnant women in Nigeria, available evidence from advanced nations has associated exposure to secondhand smoke with poor obstetrics outcomes such as low birth weight among others.[ 1 , 21 , 22 , 35 , 37 , 44 ] Pathophysiobiologically, the tobacco-related obstetric complications from secondhand smoke are due to fetal oxygen deprivation and placental anomalies induced by carbon monoxide, nicotine, and other toxic chemicals in secondhand smoke.[ 37 , 45 , 46 ]

The major source of awareness of information on the health effects of secondhand smoking was radio media advert. This similar to reports from a community-based study in Umuahia, Southeast Nigeria, Enugu,[ 47 ] Enugu, Southeast Nigeria,[ 48 ] and Ilorin, Western Nigeria.[ 48 ] The finding of radio advert as the most common source of information on dangers of secondhand smoking among the study respondents could be attributed to media message on firsthand smoking with primary objective of sponsors of radio jingles on warning on cigarette smoking which was previously that “smoking is dangerous to health” then currently that “smokers are liable to die young” in accordance with the mandate of the Federal Ministry of Health of Nigeria which is in agreement with the global tobacco control framework. However, studies in Nigeria have shown that such oral messages do not convey the magnitude of health effects of firsthand smoking[ 38 , 39 , 40 ] or exposure to secondhand smoke.[ 39 , 47 , 48 ] There is advocacy on the use of pictures to convey various organ and corporal system damage that are caused by smoking with favorable reports discouraging would-be smokers as well as persuading smokers to quit. There is a need to explore the effects of pictorial messages on pathologic insults of active and passive smoking among Nigerians. Multi-level tobacco-control strategies should therefore include exposures to secondhand smoke to protect innocent never-smoked individuals while warning on cigarette packets should also include information on deleterious effects of secondhand smoke on the health of adult, children, and pregnant women.

Limitations of the study

The limitations of this study are recognized by the researchers. First and foremost, the study was hospital-based design. Hence, the results of this study may not be general conclusions regarding respondents in the community. Second, the sampled population was drawn from hospital attendees in the primary care clinic of the hospital. Thus, extrapolation of the results of this study to the entire patients in the hospital should be done with caution because the findings may not be a true representation, of what may be obtained in the other clinics of the hospital. Third, this study was dependent in self-reported awareness of health effects of secondhand smoke and there is likelihood of under-reporting or over-reporting. More so, the respondents were studied in a clinical setting and were likely to have more awareness of the health effects of exposure to secondhand smoke.

The study has demonstrated variabilities in the awareness of health effects of secondhand smoke on adult, children, and obstetric population. The most common health effects of secondhand smoke the respondents had highest awareness were lung cancer, precipitation of asthmatic attacks, and delivery of small babies in adults, children, and obstetric population, respectively. The predominant source of awareness of information was radio advert. Awareness of general health effects on adults, children, and obstetrics population was significantly associated with exposure status.

Recommendations

The current level of awareness should be improved while effort should be intensified to address identified areas of low level of awareness through patient, family, and public health information, education, and communication. Legislation on cigarette smoking should be complemented with effective law enforcement on secondhand smoke to safeguard the health of the innocent never-smoked adult Nigerians and children. Warning on cigarette packets should also include information on deleterious health effects of secondhand smoke.

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Second-hand smoke

• Health effects of smoking and second-hand smoke
• Tobacco use and addiction
• Tobacco smoke and pregnancy

There is no safe level of exposure to tobacco smoke. Even brief exposure can be harmful to health. Footnote 1 Footnote 2 Footnote 3

On this page

Health risks of second-hand smoke, second-hand smoke is particularly dangerous in enclosed spaces.

• How to avoid exposure to second-hand smoke and reduce your health risks

You have the right to be smoke-free

Second-hand smoke refers to both the smoke coming directly from the burning end of a tobacco product and the smoke exhaled by a person who is smoking. In both situations, the smoke from the lit end of a tobacco product such as a cigarette, pipe, cigar, or hookah increases your risk of negative health effects. It contains a composition of more than 7,000 chemicals, of which hundreds are toxic and more than 70 are known to cause cancer. Footnote 1 Footnote 2 Footnote 4 Footnote 5 Footnote 6

The formation of most of these chemicals, including carbon monoxide, benzene, formaldehyde and hydrogen cyanide, occurs during the combustion process in every smoked tobacco product . Other substances, such as lead, nitrosamines and nicotine, occur naturally in the tobacco leaf and are released as the tobacco burns.

Most of the smoke from a lit cigarette is not inhaled by the person who smokes. It fills the air around them, as the cigarette continues to burn. This poses a risk to everyone's health in the area. If you do smoke, avoid smoking around others, especially children, pregnant people and people with breathing problems.

Every year in Canada, second-hand smoke causes nearly 1000 deaths from lung cancer and heart disease in non-smokers. Exposure to second-hand smoke hurts everyone. But pregnant people and their babies, infants and children are particularly at risk to suffer serious health impacts.

Learn more about tobacco smoke and pregnancy and the health impacts for infants and children.

Even healthy adults who never smoked are at risk for health problems if they breathe second-hand smoke. Second-hand smoke increases their risk of:

• heart problems
• lung cancer
• chronic obstructive pulmonary disease
• breathing problems (like asthma)
• excessive coughing
• nasal and chest infections

For more information, visit our Health effects of smoking and second-hand smoke page

For information on cannabis second-hand smoke visit Cannabis in Canada: Get the facts

Smoking in enclosed spaces (indoors - like in a home - or car) increases the risks to your health, because the level of second-hand smoke is higher in enclosed spaces. Tobacco smoke toxins remain in a room long after the original exposure has occurred.

Cancer causing chemicals and toxins in second-hand smoke cannot be completely eliminated by:

• opening windows
• using a fan, an air purifier or air freshener
• separating smoking and non-smoking sections

These harmful toxins can also cling to different materials, such as:

How to avoid second-hand smoke and reduce your health risks

The only way to protect yourself from second-hand smoke is to avoid exposure. There is no safe level of exposure to tobacco smoke. Ways to avoid tobacco smoke, including second-hand smoke include:

• quitting smoking
• helping someone quit
• avoiding indoor smoking can lower your own cigarette use and increase your chances of successfully quitting
• if you live in a multi-unit dwelling, find out how to make your home smoke-free in a multi-unit residence
• only smoke in areas where others will not be exposed to your smoke
• when smoking outside a building, make sure you are several meters away from entrances, vents and windows
• use a designated container for cigarette ashes and filters (butts)

There are laws and regulations that protect your right to smoke-free air. Smoke-free laws are in place at the federal, provincial, territorial and municipal levels to protect your health. These laws ban smoking in places such as:

• federal buildings
• bars, casinos, restaurants and patios
• planes, trains, public ferries and buses (including shelters)
• public beaches
• city-owned property (like parks and playgrounds)

For more information on regulating smoking in federal workplaces and other public places under federal control, please visit Regulating tobacco and vaping products .

For more information on policies in most other public places and in private places, check with your provincial or territorial Ministry of Health as well as your municipal government.

Related links

• Quit with confidence: deciding to quit
• Second-hand aerosol vs second-hand smoke
• Tobacco: behind the smoke (infographic)
• Tobacco: behind the smoke (video)
• Health-related messages for all tobacco product packaging: Health information messages

Page details

Health/Essays/Secondhand Smoke

Secondhand smoke is defined as cigarette, cigar, or pipe smoke that is inhaled unintentionally by nonsmokers and may be injurious to their health if inhaled regularly over a long period.

• 1 Facts about Secondhand Smoke
• 2 At Risk Groups
• 3 Smoking and Businesses
• 4 Results of Smoke-free policies
• 6 References

Facts about Secondhand Smoke

• Sidestream (directly into the air from the cigarette instead of through the interior) smoke is said to contain five times as much carbon monoxide as mainstream (through the inside of the cigarette).
• Exposure to nicotine and secondhand smoke is measured by testing the saliva, urine, or blood for the presence of a chemical called cotinine. Cotinine is a byproduct of nicotine metabolization, and tobacco is the only source of this marker.
• From 1988–91 to 2001–02, the proportion of nonsmokers with detectable levels of cotinine was halved (from 88% to 43%).
• Over that same time period, cotinine levels in those who were exposed to secondhand smoke fell by 70%.
• More than 126 million nonsmoking Americans continue to be exposed to secondhand smoke in homes, vehicles, workplaces, and public places.
• Most exposure to tobacco smoke occurs in homes and workplaces.
• Almost 60% of U.S. children aged 3–11 years—or almost 22 million children—are exposed to secondhand smoke.
• About 25% of children aged 3–11 years live with at least one smoker, compared to only about 7% of nonsmoking adults.
• The California Environmental Protection Agency estimates that secondhand smoke exposure causes approximately 3,400 lung cancer deaths and 22,700–69,600 heart disease deaths annually among adult nonsmokers in the United States.
• Each year in the United States, secondhand smoke exposure is responsible for 150,000–300,000 new cases of bronchitis and pneumonia in children aged less than 18 months. This results in 7,500–15,000 hospitalizations, annually.

(Note: a standardization of nomenclature may be in order. There is a confusion of sidestream smoke (SSS)-- directly into the air from the cigarette-- with second-hand smoke (SHS) in the sense of already in and out of the smoker's lungs before it reaches the air. The latter, SHS, is less dangerous than SSS because the smoker's lungs have removed the carbon monoxide and much other toxic $#!!+.)

At Risk Groups

Infants/Children

• Infants and young children are especially susceptible: their lungs are still developing and childhood exposure to secondhand smoke results in decreased lung function. Children who breathe secondhand smoke are more likely to suffer from cough, wheeze, phlegm and breathlessness.
• In children, exposure to secondhand smoke exacerbates 400,000-1,000,000 cases of asthma in the United States. New evidence suggests that secondhand smoke is a risk factor for induction of new cases of asthma among children and adolescents.
• The current Surgeon Generals Report states that there is no risk-free level of secondhand smoke exposure. Even brief exposures can be harmful to children.
• In the U.S., 33 percent of middle school non-smoking children and 30 percent of high school non-smoking children are exposed to secondhand smoke in their own homes. Based on levels of cotinine (a biological marker of secondhand smoke exposure), an estimated 22 million children aged 3-11 and 18 million youth aged 12-19, were exposed to secondhand smoke in the U.S. in 2000.
• Exposure to secondhand smoke causes 150,000 to 300,000 acute lower respiratory tract infections (pneumonia and bronchitis) annually in children 18 months and younger; these infections result in 7,500 to 15,000 hospitalizations each year.
• Secondhand smoke exposure causes buildup of fluid in the middle ear, resulting in 790,000 physician office visits. Middle ear infections are the most common cause of childhood operations and of childhood hearing loss.
• A California EPA study estimates that 46,000 (range is between 22,700 and 69,600) cardiovascular deaths, 3400 lung cancer deaths and 430 sudden infant death syndrome (SIDS) deaths are annually associated with secondhand smoke exposure.

Pregnant Women

• When a pregnant woman is exposed to secondhand smoke, the nicotine she ingests is passed on to her unborn baby.
• Women who smoke or are exposed to secondhand smoke during pregnancy have a higher rate of miscarriges and stillbirths, have an increased risk of low birthweight infants, have children born with decreased lung function, and have children with greater risk of sudden infant death syndrome (SIDS).
• Smoking during pregnancy causes genetic damage in the developing fetus that can be detected at birth, but also that passive - or secondary - exposure causes just as much damage as active smoking, and it is the same kind of damage.

Adults/Elderly

• Secondhand smoke exposure causes heart disease and lung cancer in nonsmoking adults.
• Nonsmokers who are exposed to secondhand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%.
• Secondhand smoke exposure causes an estimated 46,000 heart disease deaths and 3,400 lung cancer deaths annually among adult nonsmokers in the United States.
• Elderly people who live in smoky environments have worse emphysema and bronchitis, than those who live in smoke-free situations.
• Nonsmoking individuals living with heavy smokers have four times the risk of heart attack compared with those who live in smoke-free environments.

Smoking and Businesses

Smoke-free laws do not harm businesses. A comprehensive examination of smoke-free laws published in 2007 concluded that “the vast majority of scientific evidence indicates that there is no negative economic impact of clean indoor air policies, with many studies finding that there may be some positive effects on local businesses.” 1

The creation of smoke-free establishments actually has many positive effects, while those places that allow smoking see negative consequences.

• There is overwhelming scientific evidence that secondhand tobacco smoke is a direct cause of lung cancer, heart disease and lung and bronchial infections. 2
• Smoke-free laws can help smokers by giving them clear air to help them quit or at least cut back. Workers become healthier, and healthier workers miss less work, are more productive, and have lower health care costs. 3

Direct Costs

• The American Cancer Society reports that employees who smoke have an average insured payment for health care of $1,145, while nonsmoking employees average $762.26. 4
• Going smoke-free reduces cleaning and maintenance costs. The Building Owners and Managers Association, a national trade group, reports that indoor smoking increases cleaning costs and states “secondhand smoke does not belong in buildings.” 5
• The National Fire Protection Association found that in 1998 smoking materials caused 8,700 fires in non-residential structures resulting in a direct property damage of $60.5 million. 6
• Fire insurance is commonly reduced 25-30% in smoke-free businesses. 7
• Smoke-free laws add value to establishments. Restaurants in smoke-free cities have a higher market value at resale (an average of 16% higher) than comparable restaurants located in smoke-filled cities. 8
• In 2004, a Department of Health study found that the New York city's restaurants and bars prospered despite the smoking ban, demonstrating increases in liquor licenses, jobs, and business tax payments. The report stated that tax receipts increased 8.7 percent from April 1, 2003, to January 1, 2004, compared to the same period in 2002–2003. 9

Indirect Costs

• The American Productivity Audit, a national survey of over 29,000 workers, found that tobacco use was a leading cause of worker lost production time—greater than alcohol abuse or family emergencies. Quitting smoking, or even just cutting back, improves a worker’s productivity. 10
• Smokers, on average, miss 6.16 days of work per year due to sickness (including smoking related acute and chronic conditions), compared to nonsmokers, who miss 3.86 days of work per year. 11

Here is a list of some notable businesses that have already gone smoke-free:

AT&T - BASF Corporation - Bechtel - BF Goodrich Tire Manufacturing - Boeing - Bristol-Myers Squibb Calgon - Coca-Cola - Dow Chemical Company - Dunkin’ Donuts - Dupont Chemical Company - Eli Lilly and Company - Federal Express - General Mills - Hain Celestial Foods - The Home Depot, Inc. - IBM - Johnson & Johnson - Kennecott Mining - International Truck and Engine Corporation - Lowe’s Companies, Inc. - Marcal Paper Mills, Inc. - MCI Communications - Merck & Company - Nestle - Purina PetCare Company- Nike, Inc. - Proctor & Gamble - Prudential Financial - Scott Paper Company - Sharper Image - Starbucks - Subaru Auto Assembly Plant (Indiana) - Target Corporation - Texas Instruments, Inc. - Tyson Foods - Union Pacific - Verizon - Westin Hotels

Results of Smoke-free policies

• Many health benefits have resulted from smoke-free policies. The Institute of Medicine released a report in October 2009 that included eleven separate studies. Each found smoking bans led to decreases in heart attacks ranging from six to forty-seven percent.
• The American Heart Association studied and compared both North American and European communities that implemented smoke-free laws to those that did not. They found that seventeen percent fewer heart attacks occurred in communities with laws compared to communities without smoking bans within just one year of implementing smoke-free policies.
• Studies show that support for smoke-free policies increases among both smokers and nonsmoker after they are implemented. After New York implemented a statewide smoke-free policy, support rose from 25% to 37% among smokers and from 74% to 86% among nonsmokers within the first two years. 14
• Second hand smoking policies on college campuses

1 Eriksen, M. and Chaloupka, F., The Economic Impact of Clean Indoor Air Laws, CA: A Cancer Journal For Clinicians, 2007; 57:367-378. http://caonline.amcancersoc.org/cgi/content/full/57/6/367

2 Campaign for Tobacco-Free Kids. "Smoke-Free Laws Do Not Harm Business at Restaurants and Bars". www.tobaccofreekids.org/research/factsheets/pdf/0144.pdf . Accessed November 10, 2010.

3 Centers for Disease Control and Prevention. Save Lives, Save Money: Make Your Business Smoke-Free. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, June 2006. Save Lives, Save Money: Make Your Business Smoke-Free

4 "The Cost of Smoking to Business" American Cancer Society. Download at http://www.cancer.org/docroot/NWS/content/NWS_2_1x_The_Cost_of_Smoking_to_Business.asp .

5 Building Owners and Managers Association. Smoking Position Paper. Washington, DC: Building Owners and Managers Association [no date]. http://www.boma.org/Advocacy/FederalLegislativeRegulatoryIssues/Environment/SmokingPositionPaper.htm .

6 Hall, Jr., J.R., "The U.S. Smoking-Material Fire Problem," National Fire Protection Association, Fire Analysis and Research Division, April 2001.

7 "Health Now! and the business community," www.healthnowma.org

8 Taylor, A. E., Johnson, D. C., & Kazemi, H. (1992). Environmental tobacco smoke and cardiovascular disease: A position paper from the council of cardiopulmonary and critical care, American Health Association. Circulation, 86, 699-702.

9 New York City Department of Health and Mental Hygiene (2003). Initial effects of New York City smoking ordinance, from http://www.tobaccoscam.ucsf.edu/pdf/103NYC_July03.pdf

10 Stewart, WF, Ricci, JA, Chee, E, Morganstein, D. Lost productivity work time costs from health conditions in the United States: Results from the American Productivity Audit. Journal of Occupational and Environmental Medicine 2003;45(12):1234-1246.

11 Halpern, M.T.; Shikiar, R.; Rentz, A.M.; Khan, Z.M., "Impact of smoking status on workplace absenteeism and productivity," Tobacco Control 10(3): 233-238, September 2001.

12 Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence (Report Brief). October 2009. Retrieved from [1]

13 American Heart Association. Heart attack rates drop after smoking bans, continue downward over time. National Cancer Institute and American Heart Association. 21 September 2009. Retrieved from [2]

14 Centers for Disease Control and Prevention. (2011, March 11). Smoke-free policies improve health. Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/protection/improve_health/

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Study examines health impacts of second-hand cigarette smoke exposure

• Download PDF Copy

In a recent study published in Genes , researchers evaluated the effects of chronic second-hand smoke (SHS) exposure on cognition, behavior, neuropathology, and metabolism.

SHS exposure is prevalent globally and linked to neurological impairments and neurodegenerative diseases such as mild cognitive impairment (MCI), dementia, and stroke. However, the biological mechanisms by which second-hand smoke affects brain cells require elucidation, warranting further research.

Studies have highlighted the influence of gut microbial dysbiosis on neurodegeneration. The gut microbiota can affect cognitive and behavioral performance via the gut-brain axis. SHS inhalation can affect the intestinal tissue and alter the gut microbial composition. These findings raise concerns regarding cognitive decline associated with gut alterations, which are induced by SHS.

About the study

In the present study, researchers investigated whether SHS exposure induces gut microbial alterations, impacting cognitive performance, behavior, and neuropathology.

The team employed wild-type (WT) murine animals and a human tau-expressing murine model of Alzheimer's disease, who were exposed to 30 mg per cubic meter of SHS over 10 months. The researchers investigated the impact of SHS on the formation of cells labeled with p21, an early biological marker of senescence that is enhanced in bronchial cells after exposure to cigarette smoke.

Histopathological, immunohistochemical, and genetic analyses were performed on murine lung and brain tissues. Damage to deoxyribonucleic acid (DNA) caused by oxidative stress was assessed using 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels.

Furthermore, the levels of the DNA repair marker AP endonuclease 1 (APE1) were compared in SHS- and air-exposed mouse rats. Following SHS exposure, the levels of p21 and beta-galactosidase were also measured in mice.

The researchers also looked at whether oxidative DNA damage caused by SHS was connected to object recognition test performance. Fecal samples and tissues were collected from all 62 murine mice, and the feces were sequenced for the 16S ribosomal ribonucleic acid (rRNA) gene. Polymerase chain reaction (PCR) and amplicon sequence variant (ASV) clustering studies were also performed.

To assess hippocampus-dependent memory and learning, water maze and Y maze tests were used. Multivariate regression modeling was used to investigate the relationships between gut alpha and beta diversity and factors such as SHS exposure, genotype, sex, and 10 behavioral physiological covariates.

The SHS exposure influenced the gut microbial composition, biodiversity, and evenness in a gender-dependent manner. This change in gut microbiome biodiversity and composition was similarly related to various cognitive function measures, demonstrating that the intestinal microbiota contributes to the impact of second-hand smoke exposure on cognitive abilities.

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The proportion of cells labeled with 8-OHdG within the CA1 hippocampal site was likewise related to new object recognition test performance, concordant with the urinary and serological 8-OHdG levels. In SHS-exposed mice compared to sham-exposed mice, nuclear staining of cells labeled with p21 was more pronounced in bigger cells situated within the prefrontal cortical region and CA1 neurons in the hippocampus.

Furthermore, compared to air-exposed mice, SHS-exposed animals had a considerably higher percentage of tagged prefrontal cortex cells and the CA1 hippocampal region. The findings indicated that SHS exposure may accelerate brain aging characterized by cell damage caused by oxidative stress. The brains of wild-type mice, especially male mice, were vulnerable to the effects of prolonged SHS exposure.

APE1 levels in the prefrontal cortex were greater in SHS-exposed murine mice than in air-exposed murine animals. Male mice exposed to SHS had considerably more alpha diversity in their microbiomes than female mice. Female mouse microbiome diversity was equivalent to that of air-exposed mouse microbiome diversity.

The gut microbiome's alpha diversity was also linked to numerous indicators of cognitive ability. While male and female mouse microbiomes appear to be statistically identical in air-exposed mice, male and female mouse microbiomes take on unique compositions compared to one another in SHS-exposed animals.

The water and Y maze tests’ findings indicated a link between gut microbiota alpha diversity and hippocampus-dependent memory and learning. However, contradictory associations between microbiological richness and the two water maze tests were found, demonstrating that the link between alpha diversity and spatial memory retention was complicated.

Conclusions

Overall, the study findings showed that gut microbial composition, richness, and evenness were impacted by SHS exposure, and these changes were linked to cognitive impairments. SHS exposure significantly impacted cognitive performance, with increased 8-OHdG levels in the CA1 hippocampal region linked to the novel object recognition test performance.

In particular, the proportion of 8-OHdG-labeled cells in the CA1 region negatively correlated with the frequency of and time spent exploring novel objects. In addition, SHS exposure may result in accelerated brain aging through oxidative stress-induced injury.

• Raber J, Stagaman K, Kasschau KD, et al. (2023). Behavioral and Cognitive Performance Following Exposure to Second-Hand Smoke (SHS) from Tobacco Products Associated with Oxidative-Stress-Induced DNA Damage and Repair and Disruption of the Gut Microbiome. Genes , 14, 1702. doi: 10.3390/genes14091702 . https://www.mdpi.com/2073-4425/14/9/170

Posted in: Medical Research News | Medical Condition News

Tags: Aging , Alzheimer's Disease , Brain , Cell , Chronic , Cigarette , Cognitive Function , Cortex , Dementia , DNA , DNA Damage , Dysbiosis , Endonuclease , Frequency , Gene , Genes , Genetic , Gut-Brain Axis , Hippocampus , Metabolism , Microbiome , Neurodegeneration , Neurodegenerative Diseases , Neurons , Oxidative Stress , Polymerase , Polymerase Chain Reaction , Research , Ribonucleic Acid , Stress , Stroke , Tobacco

Pooja Toshniwal Paharia

Pooja Toshniwal Paharia is an oral and maxillofacial physician and radiologist based in Pune, India. Her academic background is in Oral Medicine and Radiology. She has extensive experience in research and evidence-based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.

Please use one of the following formats to cite this article in your essay, paper or report:

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Toshniwal Paharia, Pooja Toshniwal Paharia. "Study examines health impacts of second-hand cigarette smoke exposure". News-Medical . 22 August 2024. <https://www.news-medical.net/news/20230829/Study-examines-health-impacts-of-second-hand-cigarette-smoke-exposure.aspx>.

Toshniwal Paharia, Pooja Toshniwal Paharia. "Study examines health impacts of second-hand cigarette smoke exposure". News-Medical. https://www.news-medical.net/news/20230829/Study-examines-health-impacts-of-second-hand-cigarette-smoke-exposure.aspx. (accessed August 22, 2024).

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Secondhand Smoke

Secondhand smoke is smoke exhaled by another person who's smoking. It also comes from the lit end of tobacco products, like cigarettes and cigars. Secondhand smoke is a dangerous mixture of over 7,000 chemicals, including 70 that cause cancer. Secondhand smoke causes early death and disease in both children and adults who do not smoke. It increases the risk for heart attacks, heart disease, stroke, and lung cancer.

It's estimated that secondhand smoke caused nearly 34,000 heart disease deaths for nonsmokers each year between 2005 and 2009. There is no safe level of secondhand smoke exposure.

Health Effects

• Almost 3 million children in the United States under the age of 6 years old breathe secondhand smoke at home at least 4 days per week.
• Breathing in secondhand smoke at home or at work increases a person’s chances of getting lung cancer by 20-30 percent.
• More than 1 in 3 nonsmokers who live in rental housing are exposed to secondhand smoke.
• Secondhand smoke exposure is higher among children ages 3-11 years old, blacks, people living below the poverty level, and those who rent housing.

Children are vulnerable to the risks of secondhand smoke because they're still growing.

Children whose parent or guardian smokes in the home or vehicle may be at increased risk for disease and illness. Secondhand smoke increases the risk of sudden infant death syndrome (SIDS) for infants.

Protect Your Loved Ones

When you or your family members are around someone who smokes, you are all inhaling harmful chemicals that can cause smoking-related illnesses and diseases. The only way to protect yourself and your loved ones is to completely avoid secondhand smoke.

What you can do:

• If you or someone you know smokes, call Quitline Iowa at 1-800-QUIT-NOW for free access to a Quit Coach to help you quit tobacco use.
• Make your home and vehicle 100% smoke-free. Air filters, ventilation systems and cracked windows do not entirely eliminate secondhand smoke.
• Teach your children to stay away from secondhand smoke.
• If you live in multi-unit housing, choose a smoke-free building. Smoke can travel through ventilation systems, doors, windows, and cracks in the walls. Ventilation systems and air filters cannot completely eliminate secondhand smoke.

Protecting People From Secondhand Smoke

Many children and families in Iowa are still exposed to secondhand smoke in homes, cars, and parks. Eliminating smoking indoors is the only way to protect people from secondhand smoke.

Community Policies

Local Iowa communities are bringing cleaner, safer air to residents by working with local property managers and to implement smoke-free housing policies.

Smoke-Free Homes

Smoke Free Homes, a program of the Iowa Department of Health and Human Services, provides smoke free rental property listings on the Smoke Free Homes Registry free as a public service (there are currently over 1,500 listings). The program works to eliminate second and thirdhand smoke exposure for renters, to help create a safer and healthier living environment. By providing model policies, free signage, cessation materials, and technical assistance, our goal is to increase smoke free housing opportunities for all Iowans.

Stop Smoking Indoors

Parents can help protect their families from secondhand smoke by eliminating smoking in their home and car, asking people not to smoke around their family and children, or by quitting tobacco altogether. Learn more about Quitting Tobacco .

Iowa Smokefree Air Act

In 2008, Iowa lawmakers passed legislation to protect most Iowans from Secondhand Smoke. The Smokefree Air Act prohibits smoking in almost all public places and enclosed areas within places of employment, as well as some outdoor areas.

The law applies to: restaurants, bars, outdoor entertainment events, and amphitheaters. It also covers places of employment such as office buildings, health care facilities, and child care facilities. Smoking is allowed on the gaming floor of a licensed casino, as well as in designated hotel and motel rooms.

Second Hand Smoke Essay

Everybody has met with such event in their everyday life. It is hard to disagree that such situations aren’t occasional. We become victims of second hand smoke at the bus stations, near the shops or even in school yards and still have no tool to fight against this problem. Maybe, the worst is that usually kids suffer from it, especially when their parents are active smokers. Second hand smoke usually results in heart and lung diseases, cancer, acne and so on. Here are some arguments that prove harmfulness of it and show that results may be terrible.

Risk of Disease

Second hand smokers have a big chance to get several types of cancer. Every year thousands of passive smokers die because of lung or breast types of this illness. In many cases, these people have a healthy lifestyle with no smoking or drinking. The risk of lung diseases such as asthma or tuberculosis infection becomes higher as well. The worst thing is that during pregnancy women are not insured of second hand smoking. As a result, there can be premature birth, low child’s weight and other unpleasant defects. In addition, you cannot protect yourself from it because there is a risk zone everywhere; people smoke even near the hospitals. Some smokers do it for years and don’t suffer from lung illness or other ones, however, their nearest and dearest become victims of this bad habit and demand a costly and hard treatment with no guarantee of full recovery.

Children Suffers

Nowadays, kids often become victims of passive smoking. They are the most vulnerable, as their bodies are growing and not all processes of organs formation are finished. It happens as a rule if their parents have such a habit and they don’t care about their child’s health. As a result, at the young age one meets with a risk of various diseases as lung infections, asthma, allergies, middle ear infections, slow growing and so on. The point is they cannot avoid it or protect themselves if the adults don’t understand how harmful this is.

Home pets are also suffering from passive smoking even not realizing this. Dogs, cats, rabbits, birds and so on: all of them can get lots of illnesses if their owner smokes. As animals have a better smell, they are affected by tobacco fume and get a risk to gain nasal or lungs cancer. They need a complicated and hurtful treatment as chemotherapy and surgeries. However, many proprietors don’t realize how dangerous their habit may be for their pets and they continue smoking even while just walking with dog in the morning. If one loves their home pet, they should respect and care of its health, that means breaking the habit or at least putting a pet out of the risk zone.

To sum up, active smokers are not the only one who suffer from tobacco fume; others are in a great danger as well. That means that smoking in public places should be forbidden and punished strictly as it influences pregnant women and kids badly. Second hand smoking is the reason why innocent people become victims of terrible diseases.

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Best Health Essay Examples

Second-hand smoke.

683 words | 3 page(s)

The health risks of second-hand smoke have been well documented. Individuals who are exposed to the effect of second-hand smoke are at risk of a number of adverse health outcomes, including lung cancer and asthma. Second-hand smoke pollutes the environment, one of the most important aspects of Florence Nightingale’s environmental theory. Nightingale strongly believed that a healthy environment and proper air quality and air flow was necessary to the health of the individual. Continued research into this area has indicted that Nightingale’s Environmental Theory was correct in its assumptions.

Nightingale stressed that the quality of the environment was crucial to maintaining the health of the individual. She believed that infections were related to the quality of the air and the water. She advocated for ventilation for patients to ensure that fresh air went through their rooms. This was in opposition to the thought at the time when sick rooms were closed off and became stagnant. She developed this theory during the Crimean War and was quite advanced in her thinking, which is still amazingly relevant today (Lee, Clark, & Thompson, 2013, p. 245).

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The theory’s concepts and propositions involved a paradigm shift with regards to the sanitation of the time. At this time, garbage was piled high in the cities, sewage was not handled properly, hospitals and sick rooms were not well ventilated and clean water was not available to everyone. Nightingale proposed that these aspects be changed. There was a need for sanitation reform in the country and she helped to lead it (Montiero, 1985, p. 186). . As the sanitation reform occurred, not only did the paradigm shift, but there was also an epidemiological transition as well, away from infectious diseases as a result of this. The concepts of her theory centered on several propositions including access to clean water, improved irrigation of draining ditches, particularly for sanitation, improved lighting, improved personal hygiene and cleanliness and the importance of pure air. Nightingale believed that these various environmental factors were critical to the importance of health. Science has now shown that she was correct in these. During her time, kerosene was a means for light, which is still used today. It is a contributor of indoor air pollution. In societies, such as America that does not use kerosene, there is still a problem with lack of sunlight, which leads to disease.

The limitations of the theory are few. At the time that Nightingale developed her theory, the assumptions, however, were many. She was beyond her time. Since then, science has clearly indicated that she was correct in many, if not all, of her assumptions. Furthermore, history has shown that the Sanitation Reform clearly did change the overall face of disease in America as a result of the improved sanitation and environmental decisions.

I believe the most important aspect of the theory is that humans must not continue to pollute their environment. One way that humans knowingly pollute their environment is with second-hand smoke, a significant cause of disease in individuals. Furthermore, much of this disease occurs in children. My capstone project will focus on how the environmental theory indicates that second-hand smoke is a leading cause of indoor air pollution. Children who live in homes with smokers are at a significant risk for developing asthma and severe asthma as a result of the poor air quality in the home. In 2004, 40% of children world-wide were exposed to second-hand smoke. Thirty-three percent of adults were. This leads to a tremendous health burden worldwide because of the poor air quality that these individuals are repeatedly exposed to in their homes, schools or work environments (Öberg, Jaakkola, Woodward, Peruga,et al, 2011). According to the Nightingale Environmental Theory, they could benefit from improved air quality.

• Lee, G., Clark, A. M., & Thompson, D. R. (2013). Florence Nightingale–never more relevant than today. Journal of advanced nursing, 69(2), 245-246.
• Monteiro, L. A. (1985). Florence Nightingale on public health nursing. American Journal of Public Health, 75(2), 181-186.
• Öberg, M., Jaakkola, M. S., Woodward, A., Peruga, A., & Prüss-Ustün, A. (2011). Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. The Lancet, 377(9760), 139-146.

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Ministry of Health and WHO release Global Adult Tobacco Survey Indonesia Report 2021

The Global Adult Tobacco Survey (GATS) Indonesia Report 2021 presents detailed information on tobacco use and key tobacco control indicators across the country, using globally standardized protocols and methodologies.

The report found that 34.5% of adults – 70.2 million people – used tobacco. The percentage of tobacco use among men was 65.5% and among women was 3.3%. Use of electronic cigarettes increased by 10 times in the last 10 years, from 0.3% in 2011 – when the last GATS was conducted – to 3% in 2021. 

The report found that exposure to secondhand smoke in public places continued to be high. A total of 74.2% of adults were exposed to secondhand smoke in restaurants and 44.8% in workplaces. Almost 78% of current smokers noticed health warnings on cigarette package labels. More smokers wanted to quit compared to 10 years ago; however, the number of users given advice by health care providers to quit tobacco use improved by just over 4 percentage points, from 34.6% to 38.9%. 

Across Indonesia, WHO will continue to advocate for implementation of strong tobacco control measures. This includes increased taxation of tobacco products, expansion of subnational bans on tobacco advertising, promotion and sponsorship, and stronger, more effective implementation and enforcement of smoke-free policies. 

WHO encourages policy makers and public health researchers in Indonesia and globally to access and utilize the GATS Indonesia Report 2021, to better control tobacco and achieve a healthier, more sustainable future for all. 

Download the GATS Indonesia Report 2021 and related fact sheets and datasets here:

• Global Adult Tobacco Survey Indonesia Report 2021
• Global Adult Tobacco Survey Indonesia Fact Sheet 2021
• Global Adult Tobacco Survey Indonesia Comparison Fact Sheet 2011 & 2021
• Global Adult Tobacco Survey Indonesia 2021 Datasets SPSS
• Global Adult Tobacco Survey Indonesia 2021 Datasets SAS

Media Contacts

Indonesia Communication Team