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Tobacco Smoke

Experts believe that smoking is probably the single largest cause of preventable deaths in the United States. Tobacco can be bad for your health even if you are not the one smoking.
Environmental tobacco smoke (ETS) is also called “secondhand smoke.” This refers to the smoke that is released in the air when a smoker exhales. It also refers to the smoke released from a burning cigarette, cigar or pipe.

What Is in Tobacco Smoke?

Tobacco smoke has more than 7,000 chemicals. This includes trace amounts of poisons like formaldehyde, arsenic, DDT and cyanide. More than 70 of the substances in tobacco smoke can cause cancer. Many more irritate the lungs and airways. The National Toxicology Program says secondhand smoke is a human carcinogen (cancer causing agent).

How Is Secondhand Smoke Linked to Asthma and Allergies in Young Children?

Children are at high risk of lung damage and illness from inhaled smoke. Studies have shown a clear link between secondhand smoke and asthma in children. But the studies have not proven that secondhand smoke causes asthma in children.

Secondhand smoke can cause serious health problems in children.

  • Studies show that older children whose parents smoke get sick more often. Their lungs grow less than children who do not breathe secondhand smoke. They also get more bronchitis and pneumonia.
  • Wheezing and coughing are more common in children who breathe secondhand smoke.
  • Secondhand smoke can trigger an asthma attack in a child. Children with asthma who are around secondhand smoke have worse and frequent asthma attacks.
  • More than 40 percent of children who go to the emergency room for asthma live with smokers.
  • Children whose parents smoke around them get more ear infections. They have fluid in their ears more often. They also have more operations to put in ear tubes for drainage.

What Is Thirdhand Smoke?

Thirdhand smoke is residue from tobacco smoke. When a cigarette is smoked, chemicals in the smoke stick to surfaces and dust for months after the smoke is gone. The chemicals in the residue then react to other pollutants in the air, like ozone, to create harmful particles you can easily inhale.1

Thirdhand smoke particles are extremely tiny, easily making their way into your lungs. These particles can stick to skin and clothing. Adults and children then breathe in the residue or absorb it through their skin or mouth. Some experts believe thirdhand smoke may be worse for those with asthma than nicotine.

Smoking outdoors does not reduce the threat of thirdhand smoke. Airing out rooms or cars doesn’t help. Open windows, fans, air filters or confining smoking to certain rooms or outside will not reduce thirdhand smoke either.

The effects of tobacco go beyond its smoke. Doctors measure cotinine, a chemical found in tobacco, to find out how much nicotine in the body. Cotinine can be found in the urine of those who come in contact with thirdhand smoke.

What Is the Link Between Smoke and Teens?

Secondhand smoke exposure is responsible for more asthma episodes in teenagers. There is evidence that teens exposed to secondhand smoke perform worse on lung function tests. They also have higher cholesterol levels and may be more likely to get heart disease as adults.

Fortunately, teens don’t smoke as much as they used to. Even though only 13 percent of high school students say they currently smoke cigarettes (traditional or electronic), 46 percent have tried a tobacco product.

Many communities and local governments are trying to control tobacco advertising aimed at teens. The topic has been in the media a lot recently. In some states, parents who smoke have trouble getting custody in divorce cases.

How Can You Reduce Your Family’s Exposure to Secondhand and Thirdhand Smoke?

As a parent, you can limit your children’s exposure to tobacco smoke. To do this, you can quit smoking yourself, if you are a smoker. You can also ask guests to not smoke in or near your house or car. Wherever possible, protect your kids from secondhand and thirdhand smoke.

Quitting is not easy, but it is possible. Stop-smoking programs, counseling and products like nicotine gum or patches can help. Your doctor should be able to help you. Until you quit, do not smoke around your child, in your home or in your car.

Choose childcare carefully so your children will not suffer from the harmful effects of secondhand and thirdhand smoke. Remember, children exposed to secondhand and thirdhand smoke may get sick more often. Protecting them from exposure is good preventive medicine. Your child’s health depends on it.

Where Can I Get Help to Quit Smoking?

There is free help and resources available by phone, online or mail from the CDC. Call 1-800-QUIT-NOW (1-800-784-8669). Callers are routed to their state quit lines, which offer several types of information and services. These may include:

  • Free support, advice and counseling from experienced coaches
  • A personalized quit plan
  • Practical information on how to quit, including ways to cope with nicotine withdrawal
  • The latest information about stop-smoking medicines
  • Free or discounted medicines (available for some callers in most states)
  • Referrals to other resources
  • Mailed self-help materials

If you prefer online help, visit You will find online resources like:

  • Live help chat
  • Building a quit plan
  • SmokefreeTXT
  • QuitSTART app
  • Links to Smokefree Espaňol, Smokefree Teen, Smokefree Women, SmokefreeVET

Medical Review August 2017.


[1] Emerging Evidence and Arguments for a Multidisciplinary Research Agenda. Environmental Health Perspectives, 119(9), 1218–1226.

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