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Information provided by:
Coalition for a Tobacco Free Hawaiʻi
1500 South Beretania, Suite 309
Honolulu, HI 96817
Tel: 808-946-6851
Fax: 808-946-6197

Secondhand Smoke
  • What is it?
    Secondhand smoke, also known as environmental tobacco smoke (ETS) or passive smoke, is a mixture of two forms of smoke from burning tobacco products:

    • Sidestream smoke: smoke that comes directly from a lighted cigarette, pipe or cigar
    • Mainstream smoke: smoke that is exhaled by a smoker

    When nonsmokers are exposed to secondhand smoke it is called involuntary smoking or passive smoking. Nonsmokers who are exposed to secondhand smoke absorb nicotine and other compounds just as smokers do. The greater the exposure to secondhand smoke, the g reater the levels of these harmful compounds are in your body.
  • Why is it a Problem?
    The US Environmental Protection Agency (EPA) has classified secondhand smoke as a Group A carcinogen, which means that there is sufficient evidence that it causes cancer in humans. The Group A designation has been used by the EPA f or only 15 other pollutants, including asbestos, radon, and benzene.

    Secondhand tobacco smoke contains over 4,000 chemical compounds. More than 40 of these are known or suspected to cause cancer, and many of these chemicals also appear in processed tobacco.

    Secondhand smoke can be harmful in many ways. In the United States alone, each year it is responsible for:

    • An estimated 35,00 to 40,000 deaths from heart disease in people who are not current smokers
    • About 3,000 lung cancer deaths in nonsmoking adults
    • Other respiratory problems in nonsmokers, including coughing, phlegm, chest discomfort, and reduced lung function.
    • 150,000 to 300,000 lower respiratory tract infections (such as pneumonia and bronchitis) in children younger than 18 months of age, which result in 7,500 to 15,000 hospitalizations
    • Increases in the number and severity of asthma attacks in about 200,000 to 1 million asthmatic children

    The 1986 Surgeon General’s report on the Health Consequences of Involuntary Smoking reached many important conclusions about secondhand smoke including:

    • Involuntary smoking causes disease, including lung cancer in healthy nonsmokers
    • Separating smokers and nonsmokers within the same are space may reduce but does not eliminate the exposure of nonsmokers to secondhand smoke
  • Where is it a Problem?
    There are three locations where you should be especially concerned about exposure to secondhand smoke:

    Your Workplace: Secondhand smoke meets the criteria to be classified as a potential cancer-causing agent by the Occupational Safety and Health Administration (OSHA). OSHA is the federal agency responsible for health and safety in the workplace. The National Institute for Occupational Safety and Health, another federal agency, also recommends that secondhand smoke be considered a potential occupational carcinogen. Because there are no known safe levels, they recommend that exposures to secondhand sm oke be reduce to the lowest possible levels.

    Aside from protecting nonsmokers, workplace smoking restrictions also encourage smokers who wish to quit or reduce their consumption of tobacco products.

    Public Places: Everyone is vulnerable to secondhand smoke exposure in public places, such as restaurants, bars, shopping centers, public transportation, schools, and daycare centers. Although some businesses are reluctant to go smoke-free, there is no credible evidence that being smoke-free is bad for business. Public places where children go are a special area of concern.

    Your home: Making your home smoke-free is perhaps one of the most important things you can do. Any family member can develop health problems related to secondhand smoke. A smoke-free home protects your family, your guests, and even your pets.
  • What can be Done?
    Local, state, and federal authorities can enact public policies to protect people from secondhand smoke and to protect people form tobacco-caused diseases and addictions. Because there are no safe levels of secondhand smoke, it is important that any such policies be as strong as possible.


    American Cancer Society. Cancer Facts and Figures 2002. Atlanta, GA. 2002

    Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute of Occupational Safety and Health. Current Intelligence Bulletin 54: Environmental Tobacco Smoke in the Workplace – Lung Cancer and Other Healt h Effects. (Publication No. 91-108) http://www/cdc/gov/niosh/nasd/docs/as73000.html. Accessed 4/6/01

    Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and other Disorders. Washington, DC: Environmental Protection Agency; 1992. (Report # EPA/600/6-90/006F)

    Glantz, Stanton. “Tobacco Biology and Politics,” Health Edco, 1992.

    Patten, et al. “Workplace Smoking Policy and Changes in Smoking Behavior in California: A suggested Association,” Tobacco Control 1995; 4:36-41.

    Department of Health and Human Services. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. Washington, DC: Department of Health and Human Services; 1986. (Publication #HPS 87-8398)