Secondhand Smoke 
(Passive Smoke and Environmental Tobacco Smoke) 


Secondhand Smoke As A Workplace Problem

Secondhand smoke is a mixture of the smoke given off by the burning end of a cigarette, pipe, or cigar, and the smoke exhaled from the lungs of smokers. This mixture contains more than 4,000 substances, more than 40 of which are known to cause cancer in humans or animals and many of which are strong irritants. Secondhand smoke is also called environmental tobacco smoke (ETS); exposure to secondhand smoke is called involuntary smoking, or passive smoking. [i]

Secondhand smoke has been classified by the U.S. Environmental Protection Agency (EPA) as a known cause of lung cancer in humans (Group A carcinogen). i

Passive smoking is estimated by EPA to cause approximately 3,000 lung cancer deaths in nonsmokers each year. i

In 2000, 64.7% of Missouri smokers thought that smoking should not be allowed at all in indoor work areas. [ii]

More than one third (34.5 percent) of Missouri adults reported that someone had smoked cigarettes, cigars or pipes inside their home in the past 30 days. ii

Almost half of Missouri’s middle school students report they live with someone that smokes cigarettes and 94% of them believe that the smoke from someone else’s cigarettes is harmful to them. ii

A recent study reported workers in service occupations, lower income, less educated, and blue-collar workers are exposed to higher rates of secondhand smoke. The study also reported that certain racial/ethnic groups (e.g. Blacks, American Indians) may be at higher risk of ETS exposure. [iii]

Secondhand Smoke Affects Children

Infants and young children whose parents smoke are among the most seriously affected by exposure to secondhand smoke, being at increased risk of lower respiratory tract infections such as pneumonia and bronchitis. EPA estimates that passive smoking is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age annually, resulting in between 7,500 and 15,000 hospitalizations each year. i

The developing lungs of young children are also affected by exposure to secondhand smoke. Children exposed to secondhand smoke are also more likely to have reduced lung function and symptoms of respiratory irritation like cough, excess phlegm, and wheeze. i

Passive smoking can lead to buildup of fluid in the middle ear, the most common cause of hospitalization of children for an operation. i

Asthmatic children are especially at risk. EPA estimates that exposure to secondhand smoke increases the number of episodes and severity of symptoms in hundreds of thousands of asthmatic children. EPA estimates that between 200,000 and 1,000,000 asthmatic children have their condition made worse by exposure to secondhand smoke. Passive smoking may also cause thousands of non-asthmatic children to develop the condition each year. i

[i] U.S. Environmental Protection Agency, Indoor Air – Secondhand Smoke, “What you can do about secondhand smoke as a parent, decision-makers, and building occupants.”

[ii] Missouri Department of Health and Senior Services, "Clearing the Air: The Burden of Tobacco Use in Missouri," July 2002.

[iii] Brownson RC, Figgs LW, Caisley LE.; Epidemiology of environmental tobacco smoke exposure.; Oncogene 2002 Oct 21;21(48):7341-8

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Missouri Partnership on Smoking or Health, 420 E. State Street, Suite A, Jefferson City, MO 65101