What is secondhand smoke?
Secondhand smoke is the smoke or aerosol exhaled by a person who smokes any type of lighted or heated product. It is also the smoke or emission released directly from the product while it burns or heats. While the percentage of US adults that smoke cigarettes has reached a new low dropping below 10%, smoking and secondhand smoke exposure remain leading causes of preventable death and disease.  

Is secondhand smoke really bad for your health? Yes!
People who do not smoke but are exposed to secondhand smoke are still inhaling many of the same poisons and cancer-causing substances as people who smoke. Many people associate the dangers of secondhand smoke only with cigarettes. But research over the past two decades has made something clear: secondhand smoke from all smoked and vaped products—cigarettes, cigars, marijuana, electronic cigarettes, and hookah—contains harmful pollutants that can damage heart and lung health in addition to other health impacts.   

This mixture can contain:
* Fine particulate matter (tiny particles that lodge deep in the lungs)
* Cancer-causing chemicals
* Heavy metals
* Toxic gases
* Nicotine or other psychoactive compounds 

Whether the source is burning tobacco, burning cannabis, or heating a nicotine or plant-based liquid in electronic vaping or hookah devices, people nearby can still be exposed to toxic chemicals, fine particles, and other hazardous compounds. Understanding these risks is important for protecting workers, families, and communities who may not choose to smoke or vape but are still at risk for breathing the toxic air. 

There is no safe level of exposure to secondhand smoke
It doesn’t take long for someone to realize the impact of being exposed to secondhand smoke. Exposure can induce itchy, watery eyes, coughing, and breathing difficulty. It can interfere with the normal functioning of the heart, blood, and vascular systems in ways that can trigger asthma attacks and even increase the risk of having a heart attack. Health authorities such as the U.S. Surgeon General and the World Health Organization have repeatedly concluded that there is no safe level of exposure to secondhand smoke.  

Different Products, Similar Health Effects
Secondhand smoke, of any kind, is bad for public health. While the specific chemicals vary by product, the key point remains the same: shared air becomes polluted when smoking or vaping occurs. 

Cigarettes
Secondhand cigarette smoke contains thousands of chemicals, including dozens known to cause cancer, and has been linked to serious health effects in people who do not smoke. 

Secondhand smoke exposure from combustible cigarettes is associated with:
–       Lung cancer
–       Heart disease
–       Stroke
–       Asthma attacks
–       Sudden Infant Death Syndrome (SIDS)
–       Respiratory infections in children  

Cigars
Cigar smoke is often misunderstood as less harmful than cigarette smoke, but it contains many of the same toxic chemicals. Large cigars can contain as much tobacco as an entire pack of cigarettes, and when burned, they produce high levels of carbon monoxide, cancer-causing chemicals, and dangerous fine particulate matter. 

Secondhand cigar smoke can expose people nearby to similar levels of toxins as cigarette smoke, particularly in indoor environments like lounges or bars. Even if a person who smokes cigars does not inhale deeply, secondhand cigar smoke still fills the surrounding air, affecting the people around them including workers, musicians, and bystanders. 

Cannabis (Marijuana)
Studies show that being near people who are using inhaled cannabis is hazardous to a person’s health. Secondhand smoke from cannabis contains many of the same harmful combustion products found in tobacco smoke, including fine particles, carbon monoxide, volatile organic compounds, and other compounds which can cause cancer. Some studies show that indoor cannabis smoking can create particulate pollution levels comparable to or even higher than tobacco smoke. 

People exposed to secondhand cannabis smoke may experience: 

–       Irritation of the eyes and respiratory system
–       Induced asthma attacks
–       Inhalation of psychoactive compounds such as THC
–       Potential cardiovascular and respiratory effects including asthma, bronchitis, or COPD 

Electronic Cigarettes (Vapes)
Electronic cigarettes heat a liquid to create an aerosol rather than burning tobacco. Because there is no combustion and sometimes little to no visible smoke, some people assume they pose no risk to bystanders. The aerosol from electronic smoking devices is not “harmless water vapor.” The aerosol contains nicotine, ultrafine particles and low levels of toxins that are known to cause cancer. When people who do not smoke are around someone who is using e-cigarettes, they are breathing a toxic aerosol of exhaled nicotine, ultra-fine particles, volatile organic compounds, and flavored chemicals linked to lung damage.   

Hookah 
Hookah smoking involves heating flavored tobacco with charcoal and passing the smoke through water before inhalation. Despite common myths, the water does not remove most toxic substances.

Hookah smoke contains:
–       Carbon monoxide from charcoal
–       Fine particulate matter
–       Nicotine
–       Tar
–       Cancer-causing chemicals 

Hookah sessions often last 45 minutes to an hour or longer, which can create prolonged indoor pollution. Studies show that air quality inside hookah lounges can reach extremely high levels of harmful particles, exposing both customers and employees to significant secondhand smoke. Hookah users can be exposed to 9 times more carbon monoxide and 1.7 times more nicotine than from a single cigarette.  

Ventilation and “Smoking Sections” Don’t Work
Some venues try to manage exposure to secondhand smoke through ventilation systems, air filters, or separate smoking areas. However, public health research consistently shows that ventilation systems do not protect people who do not smoke from secondhand smoke exposure. Secondhand smoke spreads quickly through indoor spaces and ventilation systems remove odors and not toxins, leaving workers and patrons exposed to toxic air.  

Only 100% Smokefree Laws Protect Health 
Smokefree laws are designed to protect people who do not smoke as well as worker health and safety. Workers in hospitality venues, casinos, lounges, and other indoor workplaces often face the highest risks because they cannot easily avoid exposure during their shifts. As reported by the US Surgeon General in 2006 and affirmed in 2024, there is no risk-free level of secondhand smoke exposure and 100% comprehensive smokefree laws that apply to todo emissions in todo places, including workplaces, restaurants, bars, and casinos, have the greatest public health impact. 

Comprehensive smokefree policies help ensure that employees can work in safe environments and that indoor air stays safe for everyone. Regardless of the product—cigarettes, cigars, marijuana, e-cigarettes, or hookah—smoke and aerosol released into shared air can harm heart and lung health. Comprehensive clean indoor air policies are one of the most effective ways communities can protect public health. Everyone deserves to breathe smokefree air, no matter where you live, work or play. Consider talking with your coalition today about where your friends and neighbors are exposed to secondhand smoke and what policy options can be considered as a solution. 

ONJEWEL SMITH 
Onjewel Smith has worked in the nonprofit sector for more than 20 years helping organizations and communities build their capacity for sustainable change. She has conducted sessions on grassroots advocacy, coalition building, strategic planning, and fundraising. Throughout her career, Ms. Smith has helped develop strategic alliances between local coalitions, community-based organizations, and elected officials. She currently serves as a Southern States Strategist for the American Nonsmokers’ Rights Foundation, providing technical assistance in the areas of community organizing, grassroots advocacy, and policy change. 

TRACI KENNEDY
Traci Kennedy has served as the Midwest States Strategist for the American Nonsmokers’ Rights Foundation since 2014.  With over a decade experience in advocacy and policy, Kennedy’s work has primarily focused on worker health and safety. Kennedy has played an integral role in building a range of coalitions throughout the country, empowering voices of underserved communities, and bringing together diverse groups of business leaders, nonprofit organizations, and local decision makers.  This work has been featured in publications ranging from the New York Times to Rolling Stone, and has resulted in the passage of life-saving laws on both a state and local level. Currently, Kennedy oversees a number of casino worker-led efforts aiming to give dealers the same smokefree workplace protections as most workers in the USA.  As an alumnus of the University of Missouri for both undergraduate and graduate studies, Kennedy now resides in Des Moines, Iowa and relies on her Midwestern grit to get things done.