(updated September 2006)
Definition of Secondhand Smoke
- Secondhand smoke, also known as environmental tobacco smoke, is
a complex mixture of gases and particles that includes smoke from the
burning cigarette, cigar, or pipe tip (sidestream smoke) and exhaled
- Secondhand smoke contains at least 250 chemicals known
to be toxic, including more than 50 that can cause cancer.1
Health Effects of Secondhand Smoke Exposure
- Secondhand smoke exposure causes heart disease and lung cancer in
- 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%.2
- Breathing secondhand smoke has immediate harmful effects on the
cardiovascular system that can increase the risk of heart attack.
People who already have heart disease are at especially high risk.2
- Secondhand smoke exposure causes respiratory symptoms in children and slows their lung growth.2
- Secondhand smoke causes sudden infant death syndrome (SIDS), acute respiratory infections, ear problems,
and more frequent and severe asthma attacks in children.2
- There is no risk-free level of secondhand smoke exposure. Even brief
exposure can be dangerous.2
Current Estimates of Secondhand Smoke Exposure
- 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 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%.3
- More than 126 million nonsmoking Americans continue to be exposed
to secondhand smoke in homes, vehicles, workplaces, and public places.2
- Most exposure to tobacco smoke occurs in homes and workplaces.2
- Almost 60% of U.S. children aged 3–11 years—or almost 22
million children—are exposed to secondhand smoke.2
- About 25% of children aged 3–11 years live with at least
one smoker, compared to only about 7% of nonsmoking adults.2
- 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.4
- 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.5
- National Toxicology Program.
11th Report on Carcinogens, 2005.
Research Triangle Park, NC: U.S. Department of Health and Human Sciences,
National Institute of Environmental Health Sciences, 2000. Available from:
Accessed September 2006.
- U.S. Department of Health and Human Services.
The Health Consequences
of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
Atlanta, Georgia: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, Coordinating Center for Health Promotion,
National Center for Chronic Disease Prevention and Health Promotion,
Office on Smoking and Health, 2006. Available from:
http://www.surgeongeneral.gov/library/secondhandsmoke/report/. Accessed September 2006.
- Pirkle JL, Bernert JT, Caudill SP, Sosnoff CS, Pechacek TF. Trends
in the exposure of nonsmokers in the U.S. population to secondhand smoke:
1988–2002. Environmental Health Perspectives. 2006;114(6):853–858.
- California Environmental Protection Agency.
of Environmental Tobacco Smoke as a Toxic Air Contaminant. California
Environmental Protection Agency, final report, September 29, 2005, approved
by Scientific Review Panel on June 24, 2005. Available from:
- United States Environmental Protection Agency (EPA).
Health Effects of Passive Smoking: Lung Cancer and Other Disorders.
Office of Research and Development, EPA/600/6-90/006F, Washington, D.C.,
December 1992. Available from:
Accessed September 2006.
*Also published as: National Institutes of Health. National Cancer Institute.
Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders:
The Report of the U.S. Environmental Protection Agency. Smoking and Tobacco Control Monograph Number 4.
NIH Publication No. 93-3605, Washington, D.C., August 1993.
For Further Information
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
Media Inquiries: Contact CDC's Office on Smoking and Health press
line at 770-488-5493.
Page last updated 02/28/2007