Secondhand smoke

Secondhand smoke also known as environmental tobacco smoke, is the smoke a smoker breathes out and that comes from the tip of burning cigarettes, pipes, and cigars. Secondhand smoke contains about 4,000 chemicals. Many of these chemicals are dangerous; more than 50 are known to cause cancer. Anytime children breathe in secondhand smoke they are exposed to these chemicals.

Thirdhand smoke is the smoke left behind, the harmful toxins that remain in places where people have smoked previously. Third hand smoke can be found in the walls of a bar, upholstery on the seats of a car, or even a child’s hair after a caregiver smokes near the child.

Even if you don’t smoke, breathing in someone else’s smoke can be deadly too. Many people think that the only people harmed by tobacco use are smokers who have smoked for a long time. The fact is that tobacco use can be harmful to everyone. This includes unborn babies and people who don’t smoke. Secondhand smoke causes about 3,400 deaths from lung cancer and 22,000 to 69,000 of thousands of deaths from heart disease to nonsmoking adults in the United States each year.

Multi-unit housing like apartments or condos is also a danger- when someone smokes in a nearby unit, nonsmokers are exposed to second hand smoke- more than 1 in 3 nonsmokers living in rental housing are exposed to second hand smoke

Smoking in a different room, using fans, or smoking in front of an open window does not prevent second hand smoke.

Women exposed to secondhand smoke are more likely to have a preterm birth (a baby carried for less than 37 weeks) as well as a baby with a lower birth weight. All pregnant women should stay away from secondhand smoke and ask smokers not to smoke around them.

Millions of children are breathing in secondhand smoke in their own homes. Secondhand smoke can be especially harmful to your children’s health because their lungs still are developing. If you smoke around your children or they are exposed to secondhand smoke in other places, they may be in more danger than you realize. Children whose parents smoke only outside are still exposed to the chemicals in secondhand smoke. The best way to eliminate this exposure is to quit.

If you smoke cigarettes, cigars, or pipes, or use smokeless tobacco like chew and snuff, quit! It’s the best thing you can do for yourself and for everyone around you is quit – it will protect your loved ones from harmful secondhand smoke.

For support in quitting, including free quit coaching, a free quit plan, free educational materials, and referrals to local resources, call 1-800-QUIT-NOW (1-800-784-8669).

Secondhand smoke harms children and adults, and the only way to fully protect nonsmokers is to eliminate smoking in all homes, worksites, and public places ¹⁾.

You can take steps to protect yourself and your family from secondhand smoke, such as making your home and vehicles smokefree ²⁾.

Separating smokers from nonsmokers, opening windows, or using air filters does not prevent people from breathing secondhand smoke ³⁾.

Most exposure to secondhand smoke occurs in homes and workplaces ⁴⁾.

People are also exposed to secondhand smoke in public places—such as in restaurants, bars, and casinos—as well as in cars and other vehicles ⁵⁾.

People with lower income and lower education are less likely to be covered by smokefree laws in worksites, restaurants, and bars ⁶⁾.

You can protect yourself and your family from secondhand smoke by ⁷⁾:

• Quitting smoking if you are not already a nonsmoker
• Not allowing anyone to smoke anywhere in or near your home
• Not allowing anyone to smoke in your car, even with the windows down
• Making sure your children’s day care center and schools are tobacco-free
• Seeking out restaurants and other places that do not allow smoking (if your state still allows smoking in public areas)
• Teaching your children to stay away from secondhand smoke
• Being a good role model by not smoking or using any other type of tobacco

Benefits of quitting smoking

1. Improve your health. The health benefits of quitting smoking begin just six hours after your last cigarette! And the longer you stay quit, the healthier you’ll be.
2. Save money. Want an extra $9000 a year? If you smoke a 20-pack a day, that’s how much you’d save if you quit. Work out how much you could save – it’s a powerful motivator.
3. Regain control. At times you might feel like smoking controls you. Quitting can give you a sense of freedom, lift your mood and boost your confidence about smoking, as well as other areas of your life.
4. Positive role model. Quitting sets a great example for the children, family, friends and others around you. It can even reduce the chances of them taking up smoking themselves.
5. Family time. Quitting can give you more energy to play with your kids and more money to spend on them too.
6. Protect others. Secondhand smoke can harm others. Quitting is the only way to protect your family and friends.
7. Less hassle. Disapproving looks or comments from non-smokers can make you feel embarrassed or judged. You might even try to keep your smoking a secret. It’s also a hassle having to make sure you have enough cigarettes with you or enough money to buy them when you run out.
8. Healthier appearance. Smoking ages your skin. It also makes your clothes, hair, house and car smell terrible. When you quit, your teeth become whiter, nicotine stains on your fingers fade and the skin of your face will show less signs of aging. Your house and your car will no longer smell like an ashtray.
9. Better surgery outcomes. If you’re having surgery, quitting can lower your risk of complications and help with recovery and healing. Your surgeon is obliged to talk to you about the risks of not quitting.

Creating a smoke-free environment

The following tips may help keep your children from being exposed to secondhand smoke:

• Set the example. If you smoke, quit today! If your children see you smoking, they may want to try it, and they may grow up smoking as well. If there are cigarettes at home, children are more likely to experiment with smoking—the first step in becoming addicted.
• Remove your children from places where smoking is allowed, even if no one is smoking while you are there. Chemicals from smoke can be found on surfaces in rooms days after the smoking occurred.
• Make your home smoke free. Until you can quit, don’t smoke inside your home and don’t smoke anywhere near your children, even if you are outside. Don’t put out any ashtrays. Remember, air flows throughout a house, so smoking in even one room allows smoke to go everywhere.
• Make your car smoke free. Until you can quit, don’t smoke inside your car. Opening windows isn’t enough to clear the air and can actually blow smoke back into the faces of passengers in the back seat.
• Choose a babysitter who doesn’t smoke. Even if the babysitter smokes outside, your children are exposed. Consider changing babysitters to find a smoke-free environment for your children.
• Encourage tobacco-free child care and schools. Help your children’s child care or school, including outdoor areas and teachers’ lounges, become tobacco free. Get your children involved in the effort to make schools tobacco free!

Second hand smoke statistics

Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Nearly 40 million U.S. adults still smoke cigarettes, and about 4.7 million middle and high school students use at least one tobacco product, including e-cigarettes. Every day, about 1,600 U.S. youth younger than 18 years smoke their first cigarette. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. Another 16 million live with a serious illness caused by smoking. Each year, the United States spends nearly $170 billion on medical care to treat smoking-related disease in adults.

Many people in the United States are still exposed to secondhand smoke:

• During 2011–2012, about 58 million nonsmokers in the United States were exposed to secondhand smoke ⁸⁾.
• Among children who live in homes in which no one smokes indoors, those who live in multi-unit housing (for example, apartments or condos) have 45% higher cotinine levels (or almost half the amount) than children who live in single-family homes.9
• During 2011–2012, 2 out of every 5 children ages 3 to 11—including 7 out of every 10 Black children—in the United States were exposed to secondhand smoke regularly ⁹⁾.
• During 2011–2012, more than 1 in 3 (36.8%) nonsmokers who lived in rental housing were exposed to secondhand smoke ¹⁰⁾.

Smoking and death

Cigarette smoking is the leading preventable cause of death in the United States ¹¹⁾.

• Cigarette smoking causes more than 480,000 deaths each year in the United States. This is nearly one in five deaths ¹²⁾.
• Smoking causes more deaths each year than the following causes combined ¹³⁾:
  • Human immunodeficiency virus (HIV)
  • Illegal drug use
  • Alcohol use
  • Motor vehicle injuries
  • Firearm-related incidents
• More than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States ¹⁴⁾.
• Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths.1,2 More women die from lung cancer each year than from breast cancer ¹⁵⁾.
• Smoking causes about 80% (or 8 out of 10) of all deaths from chronic obstructive pulmonary disease (COPD) ¹⁶⁾.
• Cigarette smoking increases risk for death from all causes in men and women ¹⁷⁾.
• The risk of dying from cigarette smoking has increased over the last 50 years in the U.S ¹⁸⁾.

Smoking and increased health risks

Smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer ¹⁹⁾.

Estimates show smoking increases the risk:

• For coronary heart disease by 2 to 4 times ²⁰⁾
• For stroke by 2 to 4 times ²¹⁾
• Of men developing lung cancer by 25 times ²²⁾
• Of women developing lung cancer by 25.7 times ²³⁾

Smoking causes diminished overall health, increased absenteeism from work, and increased health care utilization and cost ²⁴⁾.

Smoking and cardiovascular disease

Smokers are at greater risk for diseases that affect the heart and blood vessels (cardiovascular disease) ²⁵⁾.

• Smoking causes stroke and coronary heart disease, which are among the leading causes of death in the United States.
• Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease.
• Smoking damages blood vessels and can make them thicken and grow narrower. This makes your heart beat faster and your blood pressure go up. Clots can also form.
• A stroke occurs when:
  • A clot blocks the blood flow to part of your brain;
  • A blood vessel in or around your brain bursts.
• Blockages caused by smoking can also reduce blood flow to your legs and skin.

Smoking and respiratory disease

Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs ²⁶⁾.

• Lung diseases caused by smoking include COPD, which includes emphysema and chronic bronchitis.
• Cigarette smoking causes most cases of lung cancer.
• If you have asthma, tobacco smoke can trigger an attack or make an attack worse.
• Smokers are 12 to 13 times more likely to die from COPD than nonsmokers.

Smoking and cancer

Smoking can cause cancer almost anywhere in your body ²⁷⁾:

• Bladder
• Blood (acute myeloid leukemia)
• Cervix
• Colon and rectum (colorectal)
• Esophagus
• Kidney and ureter
• Larynx
• Liver
• Oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils)
• Pancreas
• Stomach
• Trachea, bronchus, and lung

Smoking also increases the risk of dying from cancer and other diseases in cancer patients and survivors ²⁸⁾.

If nobody smoked, one of every three cancer deaths in the United States would not happen ²⁹⁾.

Smoking and other health risks

Smoking harms nearly every organ of the body and affects a person’s overall health ³⁰⁾.

• Smoking can make it harder for a woman to become pregnant. It can also affect her baby’s health before and after birth. Smoking increases risks for:
  • Preterm (early) delivery
  • Stillbirth (death of the baby before birth)
  • Low birth weight
  • Sudden infant death syndrome (known as SIDS or crib death)
  • Ectopic pregnancy
  • Orofacial clefts in infants
• Smoking can also affect men’s sperm, which can reduce fertility and also increase risks for birth defects and miscarriage ³¹⁾.
• Smoking can affect bone health. Women past childbearing years who smoke have weaker bones than women who never smoked. They are also at greater risk for broken bones.
• Smoking affects the health of your teeth and gums and can cause tooth loss ³²⁾.
• Smoking can increase your risk for cataracts (clouding of the eye’s lens that makes it hard for you to see). It can also cause age-related macular degeneration (AMD). Age-related macular degeneration is damage to a small spot near the center of the retina, the part of the eye needed for central vision ³³⁾.
• Smoking is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30–40% higher for active smokers than nonsmokers ³⁴⁾.
• Smoking causes general adverse effects on the body, including inflammation and decreased immune function ³⁵⁾.
• Smoking is a cause of rheumatoid arthritis ³⁶⁾.

Differences in second hand smoke exposure

Racial and ethnic groups

Cotinine is created when the body breaks down the nicotine found in tobacco smoke. Cotinine levels have declined in all racial and ethnic groups, but cotinine levels continue to be higher among non-Hispanic Black Americans than non-Hispanic White Americans and Mexican Americans. During 2011–2012 ³⁷⁾:

• Nearly half (46.8%) of Black nonsmokers in the United States were exposed to secondhand smoke.
• About 22 of every 100 (21.8%) non-Hispanic White nonsmokers were exposed to secondhand smoke.
• Nearly a quarter (23.9%) of Mexican American nonsmokers were exposed to secondhand smoke.

Income

• Secondhand smoke exposure is higher among people with low incomes.
• During 2011–2012, more than 2 out of every 5 (43.2%) nonsmokers who lived below the poverty level were exposed to secondhand smoke.

Occupation

• Differences in secondhand smoke exposure related to people’s jobs decreased over the past 20 years, but large differences still exist.
• Some groups continue to have high levels of secondhand smoke exposure. These include ³⁸⁾:
  • Blue-collar workers and service workers
  • Construction workers

Secondhand smoke harms children and adults

• There is no risk-free level of secondhand smoke exposure; even brief exposure can be harmful to health ³⁹⁾.
• Since 1964, approximately 2,500,000 nonsmokers have died from health problems caused by exposure to secondhand smoke ⁴⁰⁾.

Health effects in children

In children, secondhand smoke causes the following ⁴¹⁾:

• Ear infections
• More frequent and severe asthma attacks
• Respiratory symptoms (for example, coughing, sneezing, and shortness of breath)
• Respiratory infections (bronchitis and pneumonia)
• A greater risk for sudden infant death syndrome (SIDS)

Secondhand smoke can infiltrate into other units through hallways and stairwells.

Health effects in adults

In adults who have never smoked, secondhand smoke can cause:

• Heart disease. For nonsmokers, breathing secondhand smoke has immediate harmful effects on the heart and blood vessels ⁴²⁾. It is estimated that secondhand smoke caused nearly 34,000 heart disease deaths each year during 2005–2009 among adult nonsmokers in the United States ⁴³⁾.
• Lung cancer ⁴⁴⁾. Secondhand smoke exposure caused more than 7,300 lung cancer deaths each year during 2005–2009 among adult nonsmokers in the United States ⁴⁵⁾.
• Stroke ⁴⁶⁾.

Smokefree laws can reduce the risk for heart disease and lung cancer among nonsmokers ⁴⁷⁾.

Secondhand smoke on infants and children

• Infants exposed to secondhand smoke have about twice the risk for SIDS (Sudden Infant Death Syndrome) compared with infants living in a smoke free environment.
• Compared to children of non-smokers, the children of parents who smoke have higher rates of lung or airways infections such as bronchitis, bronchiolitis and pneumonia.
• Asthma is more common among children of smokers. Children with asthma exposed to secondhand smoke have a greater risk of getting symptoms earlier in life, and having more symptoms and asthma attacks. They are more likely to use asthma medications more often and for a longer period.
• Children of smokers have a lowering in lung function, meaning that on average, they cannot breathe in as deeply or breathe out as hard compared to children of non-smokers. Some evidence suggests that this reduced lung function may even persist into adulthood.
• Children of smokers are more likely to contract ear infections and have an increased risk of meningococcal disease, which can sometimes cause death, mental disability, hearing loss, or loss of a limb.
• Childhood cancers: leukemia, brain cancer and lymphomas (where both the pregnant mother and the child after birth were exposed to secondhand smoke).

Young children are also at risk from their own behaviors- crawling on floors and carpets is an easy way to ingest dust and smoke particles, as is putting hands in mouth after touching a surface (walls, floors, furniture) where smoke has settled.

Smoking harms infants and children

When parents expose their children to smoke, or let others do so, they are putting their children’s health in danger and sending a message that smoking is OK.

Secondhand smoke is the smoke a smoker breathes out. It’s also the smoke that comes from the tip of lit cigarettes, pipes, and cigars. It contains about 4,000 different chemicals, many of which cause cancer.

Breathing in smoke can cause:

• Asthma
• Respiratory infections (like bronchitis and pneumonia)
• Lung problems, pneumonia
• Ear infections
• Sudden infant death syndrome (SIDS) (for babies younger than 1 year)
• Tooth decay
• Sleep problems
• Developmental delays.

Children of smokers cough and wheeze more and have a harder time getting over colds. They miss many more school days too. Secondhand smoke can cause other symptoms including stuffy nose, headache, sore throat, eye irritation, and hoarseness.

Children with asthma are especially sensitive to secondhand smoke. It may cause more asthma attacks and the attacks may be more severe, requiring trips to the hospital.

Smoking harms unborn babies

Smoking during pregnancy or exposing pregnant women to smoke can lead to many serious health problems for an unborn baby, such as:

• Miscarriage
• Premature birth (born not fully developed)
• Lower birth weight than expected (possibly meaning a less healthy baby)
• Sudden infant death syndrome (SIDS)
• Learning problems and attention-deficit/hyperactivity disorder (ADHD)

Smoking harms teens

90% of smokers start before age 18. About one-third of them will die of a smoking-related disease. Other teen smokers may experience the same health problems as adult smokers, including:

• Addiction to nicotine
• Long-term cough
• Faster heart rate
• Lung problems
• Higher blood pressure
• Less stamina and endurance
• Higher risk of lung cancer and other cancers
• More respiratory infections
• Smoking also gives you bad breath, yellow teeth, and yellow fingernails; makes your hair and clothes smell bad; and wrinkles your skin.

Long-term effects of secondhand smoke

Children who grow up with parents who smoke are themselves more likely to smoke. Children and teens who smoke are affected by the same health problems that affect adults. Secondhand smoke may cause problems for children later in life including:

• Poor lung development (meaning that their lungs never grow to their full potential)
• Lung cancer
• Heart disease
• Cataracts (an eye disease)

Second hand smoke and pregnancy

If you smoke or are exposed to secondhand smoke when you’re pregnant, your baby is exposed to harmful chemicals too. When a pregnant woman breathes in secondhand smoke, chemicals from the smoke can pass through her lungs into the bloodstream. Nicotine, carbon monoxide and other chemicals can cross the placenta affecting her unborn child. This may lead to many serious health problems, including:

• Miscarriage
• Premature birth (born not fully developed)
• Lower birth weight than expected (possibly meaning a less healthy baby)
• Sudden infant death syndrome (SIDS)
• Learning problems and attention-deficit/hyperactivity disorder (ADHD)
• Decreased fetal breathing
• Learning problems
• Respiratory disorders
• Heart disease as an adult

Smoking during pregnancy can also cause:

• Orofacial clefts (cleft lip, cleft palate) in the baby
• Placenta previa (the placenta covers some or all of the cervix, causing bleeding and pre-term labor)
• Placental abruption (placenta detaches from the uterus causing bleeding in the mother and anything from increased heart rate to stillbirth in the fetus)

The health risks go up the longer the pregnant woman smokes or is exposed to smoke.

After birth, children exposed to secondhand tobacco smoke have more respiratory infections, bronchitis, pneumonia, poor lung function, and asthma than children who aren’t exposed. Smoke exposure is most dangerous for younger children because they spend more time in close proximity to parents or other smokers, and they have immature lungs.

The health risks go up the longer the pregnant woman smokes or is exposed to smoke. Quitting anytime during pregnancy helps—of course, the sooner the better. All pregnant women should stay away from secondhand smoke and ask smokers not to smoke around them.

How to quit smoking when you’re pregnant

Quitting at any time during your pregnancy will give your baby a better chance of a healthy start in life.

Expecting a baby usually increases the pressure to stop smoking. We get that, and we’re here to help. We want to let you know that there’s a lot of support out there.

Quitline counsellors are trained to help you during your pregnancy. Your midwife and doctor can also offer quitting information and support.

Tips for quitting during pregnancy:

• Gentle exercise such as swimming, walking and supervised yoga can help the body adjust to being without cigarettes.
• If your partner or other people in your household smoke, encourage them to consider quitting or to only smoke outside.
• Don’t forget you can call the Quitline for support, call 1-800-QUIT-NOW (1-800-784-8669).

Using nicotine replacement therapy products while pregnant

If you’re having trouble quitting, some nicotine replacement therapy products are an option. Using nicotine replacement therapy products is safer than smoking, but discuss the risks and benefits with your doctor or pharmacist before using it. If you plan to use nicotine replacement therapy products, you should also tell the doctor supervising your pregnancy.

If you are pregnant, the better options are the nicotine lozenge, mouth spray, gum or inhaler. These products usually provide a lower daily dose of nicotine than the patch. However, if you have nausea or sickness, you may prefer using a patch. You can use the daytime patch to help you quit, and you must remove it before going to bed. Do not use the 24 hour nicotine patch.

Do not use the nicotine patch if you are breastfeeding. If breastfeeding, you can use the nicotine gum, mouth spray, lozenge or inhaler. Breastfeed your baby first, then use your preferred nicotine product soon after.

Quitting medications – Champix (varenicline) or Zyban (bupropion) – are not recommended for women who are pregnant or breastfeeding.

When the urge to smoke strikes remember the 4Ds:

1. Delay: Delay for a few minutes and the urge will pass
2. Deep breathe: Breathe slowly and deeply
3. Do something else: Ring a friend, listen to music, or practice pre-natal exercises
4. Drink water: Take ‘time out’ and sip slowly

Secondhand smoke on adults

Secondhand smoke causes the following diseases and conditions in adults:

• Heart disease
• Lung cancer
• Stroke
• Irritation of the eyes and nose

Secondhand smoke has also been linked to:

• Cancers of the breast, throat, voice-box, nose and cervix
• Diabetes
• Disease of the blood vessels
• short term respiratory symptoms including cough, wheeze, chest tightness and difficulty breathing
• Long term respiratory symptoms
• Development of asthma and worsening of asthma control
• Chronic obstructive pulmonary disease (COPD).