What is Second-hand Smoke (SHS)?

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Tobacco smoke has been classified as a human carcinogen.

It contains more than 4000 chemicals, including more than 200 which are poisonous and at least 69 which are cancer-causing, as well as gases like carbon monoxide, which affects the body’s ability to deliver oxygen to the heart and brain.[i]^,[ii]^,[iii] The long list of carcinogenic and toxic substances that have been identified in tobacco smoke includes: tobacco-specific N-nitrosamines (TSNAs), ammonia (added to cigarettes to enhance the absorption of nicotine), benzene, formaldehyde, acetone, arsenic, butane, hydrogen cyanide (used as a genocidal agent during World War II), lead, mercury, methane, naphthalene, and even Dichloro-Diphenyl-Trichloroethane (DDT) and at least 3 other pesticides known to be unsafe and carcinogenic for humans.

Second-hand smoke (SHS), or environmental tobacco smoke, is a complex mixture of thousands of gases and fine particles emitted from the burning end of a cigarette or from other tobacco products usually in combination with the smoke exhaled by the smoker.[iv] It can linger for more than 2 hours, and may be invisible and odorless.[v]^{, [vi]}

Harms of second-hand smoke

Second-hand smoke is harmful. Inhaling second-hand smoke is just as dangerous as actually smoking. The non-smoker who inhales the smoke from a smoker’s cigarette also suffers as much harm to his body as the smoker does.[vii]^{, [viii]}

There is no safe level of exposure to second-hand smoke.^[viii], [ix]

Second-hand smoke is a significant health risk for all those exposed to it^{[vii], [viii],} [ix] -- from persons near the smoker, to the unborn child of a pregnant smoker, to someone in a room where particles from second-hand smoke linger long after the smoker has left. Even pets of smokers are affected.[ix]^{, [x], [xi]}

Consider these facts:

• Nicotine by-products have been found in non-smokers, even babies, exposed to second-hand smoke. [xii]^{, [xiii]}
• Exposure of merely 30 minutes to second-hand smoke makes blood platelets stick together and damages blood vessels, and has the same effect as a pack-a-day smoker. ^{[xiv], [xv], [xvi], [xvii]}
• Exposure of slightly more than 2 hours causes higher “bad” cholesterol levels, and puts the non-smoker at greater risk for arrhythmia (irregular heartbeat).^{[xvi], [xvii],} [xviii]

Immediate effects of exposure to second-hand smoke are coughing or wheezing, phlegm, and shortness of breath, perhaps dizziness and nausea. Long term effects are more serious. [iv]

In adults, second-hand smoke causes chronic heart disease and heart attacks, lung and breast cancer, and respiratory disease. Non-smokers who live with smokers are more likely to develop lung cancer and heart disease. Because second-hand smoke contains 20 known mammary carcinogens, non-smoking women who live with smokers are at greater risk of developing breast cancer. [iii] It can trigger and exacerbate asthma attacks, and even induce asthma in healthy individuals.^[viii], [ix]

Maternal smoking during pregnancy causes fetal growth impairment which leads to low birth weight, as well as premature delivery, and in some cases, even miscarriage. Babies born to mothers who smoke are often smaller and more likely to develop respiratory ailments than those whose mothers did not smoke, or were not exposed to second-hand smoke, during pregnancy.^{[viii], [ix], [xviii]}

Babies and children of smokers, who are thus exposed to second-hand smoke, suffer from sudden infant death syndrome, lower respiratory disease like asthma, pneumonia, bronchitis, and middle ear disease, which can lead to hearing impairment if left untreated. They also suffer from impaired lung growth function, which puts them at risk for respiratory illness as they grow older.^{[viii], [ix],} [xix]

Children of smokers have more learning difficulties and behavioral problems, like hyperactivity and decreased attention spans, than children of non-smokers.[xix]

In addition to the harm caused to health, second-hand smoke also has a negative economic impact on individuals, families, and society in general through medical and hospitalization expenses, loss of personal income, and production losses due to employee sickness and absences from work.[ii]^,[iii]

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[i] Mackay J, Eriksen M, and Shafey O.  The Tobacco Atlas, 2^nd ed. American Cancer Society, 2006.

[ii] Muller T. Global Voices for a Smokefree World: Movement Towards a Smokefree Future, Global Smokefree Partnership, 2007.

[iii] World Health Organization. Protection From Exposure to Second-hand Smoke. Policy Recommendations. Geneva, 2007. (http://www.who.int/tobacco/resources/publications/wntd/2007/who_protection_exposure_final_25June2007.pdf, accessed 24 September 2007).

[iv] Pan American Health Organization. Factsheet: How Second-hand Smoke Harms and Kills Non-smokers (http://www.paho.org/English/AD/SDE/RA/wntd-factsheet2.pdf, accessed 24 September 2007)

[v] WHO Framework Convention on Tobacco Control – Conference of Parties. Article 8: Guidelines on protection from exposure to tobacco smoke. Geneva, 2007.

(http://www.who.int/gb/fctc/PDF/cop2/FCTC_COP2_17P-en.pdf, accessed 24 September 2007)

[vi] UK National Health Service. Secondhand Smoke. Go Smokefree website.

(http://www.gosmokefree.co.uk/secondhandsmoke/, accessed 25 September 2007)

[vii] UK National Health Service. How Your Secondhand Smoke Affects Others. Go Smokefree website. (http://www.gosmokefree.co.uk/secondhandsmoke/howyoursmokeaffectsothers/, accessed 25 September 2007)

[viii] US 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. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Secondhand Smoke What It Means to You. Atlanta, Georgia: 2006. (http://www.surgeongeneral.gov/library/secondhandsmoke/secondhandsmoke.pdf, accessed 25 September 2007)

[ix] US 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. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, Georgia: 2006. (http://www.surgeongeneral.gov/library/secondhandsmoke/report/fullreport.pdf, accessed 25 September 2007)

[x] Bertone ER, Snyder LA and Moore AS. Environmental Tobacco Smoke and Risk of Malignant Lymphoma in Pet Cats. Am J Epidemiol 2002;156:268–73.

[xi] Reif JS, Bruns C, and Lower KS. Cancer of the nasal cavity and paranasal sinuses and exposure to environmental tobacco smoke in pet dogs. Am J Epidemiol 1998; 147:488–92.

[xii] Utah Department of Health. Smoking is Harmful for Pets! Utah Tobacco Prevention and Control Program website. (http://www.tobaccofreeutah.org/smokingpets.htm, accessed 23 September 2007)

[xiii] Joseph DV, Jackson JA, et al. Effect of parental smoking on cotinine levels in newborns. Arch. Dis. Child. Fetal Neonatal Ed..2007; 92: F484-F488.

[xiv] Hecht SS, Carmella SG, et al. 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol and its Glucuronides in the Urine of Infants Exposed to Environmental Tobacco Smoke. Cancer Epidemiol Biomarkers Prev 2006; 15(5):988–92.

[xv] American Cancer Society and International Union Against Cancer (UICC). Tobacco Control Strategy Planning, Companion Guide #1: Building Public Awareness About Passive Smoking Hazards. Pan American Health Organization.

(http://www.paho.org/English/AD/SDE/RA/Guide1a_SecondhandSmoke.pdf, accessed 3 November 2007)

[xvi] TobaccoScam Project, UCSF School of Medicine. Secondhand Smoke: A Little is Dangerous. TobaccoScam: Smokefree Restaurants website. (http://www.tobaccoscam.ucsf.edu/Secondhand/Secondhand_lid.cfm, accessed 28 September 2007)

[xvii] TobaccoScam Project, UCSF School of Medicine. Secondhand Smoke: Fact Sheet. TobaccoScam: Smokefree Restaurants website. (http://www.tobaccoscam.ucsf.edu/Secondhand/Secondhand_fs.cfm, accessed 28 September 2007)

[xviii] Glantz SA and Parmley W. Even a Little Secondhand Smoke is Dangerous. JAMA 2001; 286(4): 462-463.

(http://www.tobaccoscam.ucsf.edu/pdf/9.1-Glantz&Parmely-EvenALittleIsDangerous.pdf, accessed 28 September 2007)

[xix] World Health Organization Tobacco Free Initiative. International Consultation on Environmental Tobacco Smoke (ETS) and Child Health: Consultation Report. January 1999 (http://www.who.int/tobacco/research/en/ets_report.pdf, accessed 28 September 2007)

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