Fact Sheet: Secondhand Smoke

Secondhand smoke (also known as environmental tobacco smoke, involuntary smoking or passive smoking) is a complex mixture of more than 4,000 chemicals, including at least 69 known carcinogens and many more that are hazardous to health. The Framework Convention on Tobacco Control (FCTC)—the international tobacco control treaty—states that “scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.” According to the World Health Organization (WHO), secondhand smoke is a human carcinogen for which there is no “safe” level of exposure.1
Health and scientific authorities around the world agree that secondhand smoke poses a serious threat to human health and effective action must be taken to reduce exposure. Their conclusions include:

  • Secondhand smoke causes lung cancer, heart disease, chronic lung ailments such as bronchitis and asthma (particularly in children), sudden infant death syndrome and low birth weight.
  • The only effective way to eliminate the harms associated with secondhand smoke is by enacting comprehensive smoke-free laws (smoking bans) that include all indoor workplaces and public places.
  • The evidence is clear that smoke-free laws protect health without harming business or the economy.

Secondhand Smoke Harms Children and Adult Nonsmokers

The scientific evidence on the health risks associated with exposure to secondhand smoke is clear, convincing and overwhelming. The Surgeon General of the United States in June 2006 issued an authoritative scientific report on secondhand smoke, The Health Consequences of Involuntary Exposure to Tobacco Smoke, which reached the following conclusions:

  • “Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke.
  • Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in their children.
  • Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer.
  • The scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke.”2

Other studies and reports documenting the harm secondhand smoke causes to nonsmokers include:

  • In a 2005 report, the California Environmental Protection Agency (CalEPA), which is recognized as a world leader on issues related to secondhand smoke, affirmed and strengthened its previous findings regarding the harms caused by secondhand smoke. These harms include sudden infant death syndrome, asthma, increased respiratory tract infections, increased middle ear infections, low birth
    weight and impaired lung function for children, and lung cancer and heart disease for adults. CalEPA also included two significant, new findings that exposure to secondhand smoke causes nasal sinus cancer and that it causes breast cancer in younger, primarily premenopausal women.3
  • A 2004 report from the U.K. Scientific Committee on Tobacco and Health concluded that nonsmokers exposed to secondhand smoke had a 24 percent increased risk of lung cancer and a 25 percent increased risk of heart disease. Among children, the report found that scientific evidence strongly links secondhand smoke with an increased risk of pneumonia and bronchitis, asthma attacks,
    middle ear disease, decreased lung function, sudden infant death syndrome and low birth weight.
  • A 2002 report by the Word Health Organization’s International Agency for Research on Cancer (IARC) concluded that secondhand smoke causes lung cancer, heart disease and other health problems.4
      • World Health Organization: The WHO's web site states, “100% smoke-free is the only answer. Neither ventilation nor filtration, alone in or combination, can reduce exposure levels of tobacco smoke indoors to levels that are considered acceptable.”
      • The U.S. Surgeon General: “Eliminating smoking in indoor spaces fully protects nonsmokers from exposure to secondhand smoke. Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposures of nonsmokers to secondhand smoke.”5
      • The UK Scientific Committee on Tobacco and Health: “This is a controllable and preventable form of indoor air pollution...no infant, child or adult should be exposed to secondhand smoke... Secondhand smoke represents a substantial public health hazard.”6
      • indoor workplaces;
      • government buildings;
      • bars, pubs, restaurants, stores and shopping malls;
      • places of public entertainment, such as theatres, concert halls and museums; and
      • public transportation, such as buses, taxis, trains, airplanes and boats.
      • the placement of health warnings on cigarette packages advising smokers that their tobacco smoke is harmful to children and others;
      • training for physicians and other health professionals on the health impacts of secondhand smoke; and
      • programs to assist pregnant women to stop smoking.
      • The U.S. Surgeon General concluded, “Evidence from peer-reviewed studies shows that smoke-free policies and regulations do not have an adverse economic impact on the hospitality industry.”8
      • A major study in the journal Tobacco Control offered a comprehensive review of all available studies on the economic impact of smoke-free laws and concluded that: “All of the best designed studies report no impact or a positive impact of smoke-free restaurant and bar laws on sales or employment.”9
      • According to an internal industry document, the tobacco companies have developed a strategy in “every international area (USA, Europe, Australia, Far East, South America, Central America & Spain)...to set up a team of scientists organized by one national coordinating scientist and American lawyers, to review scientific literature and carry out work on ETS to keep the controversy
        alive.”(emphasis added).10
      • Tobacco companies have spent millions of dollars in an attempt to undermine the findings of a ten-year study on secondhand smoke by the research branch of WHO.11
      • Tobacco companies have secretly funded businesses and research institutes such as Healthy Buildings International, Inc. to minimize the dangers of workplace secondhand smoke through suspect research methods and advocacy work.12
      • The tobacco industry has aggressively promoted ventilation as an alternative to smoke-free environments around the world, despite the fact that ventilation technology is incapable of removing all the harmful elements in tobacco smoke.13 A 2004 U.S. study found the tobacco industry has developed a network of consultants who promote ventilation as a “solution” to secondhand smoke. The consultants, who represent themselves as independent, usually work under close, but generally undisclosed, industry supervision.14
      • Tobacco industry-funded “courtesy of choice” programs—often carried out in conjunction with the hospitality industry—attempt to equate the “right to smoke” with the right to breathe unpolluted air by promoting separate smoking areas or the above-mentioned ventilation solutions.15

      • Only Comprehensive Smoke-Free Laws Provide Effective Protection from Secondhand Smoke

      A guiding principle of the FCTC calls on governments to “protect all persons from exposure to tobacco smoke,” rather than just specific populations such as children or pregnant women. The protection should be extended “in indoor workplaces, public transport, indoor public places and...other public places.”
      Health authorities around the world agree that the only effective way to eliminate exposure to secondhand smoke is by adopting comprehensive smoke-free laws (smoking bans) that include all indoor workplaces and public places. The health authorities that have recommended such policies include:
      In recent years, a growing number of countries and provinces, states or territories have adopted comprehensive smoke-free laws. These include: Bermuda, Bhutan, England (effective July 1, 2007), France (effective 2008), Ireland, Italy, Lithuania, New Zealand, Northern Ireland, Norway, Scotland, Sweden and Uruguay.
      Comprehensive smoke-free laws prohibit smoking in the following areas:
      In addition to comprehensive smoke-free laws, the WHO recommends the following actions to reduce exposure to secondhand smoke:
      To reduce exposure to secondhand smoke in the home, where many children are exposed, WHO recommends governments launch education campaigns targeted at household decision-makers highlighting the negative impact of secondhand smoke on children and other nonsmokers.7

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