Health Effects of Secondhand Smoke

Secondhand smoke is a serious health hazard causing more than 41,000 deaths per year. It can cause or make worse a wide range of damaging health effects in children and adults, including lung cancer, respiratory infections and asthma.

The American Lung Association has more information available on laws protecting the public from exposure to secondhand smoke.

Key Facts about Secondhand Smoke

  • Secondhand smoke causes approximately 7,330 deaths from lung cancer and 33,950 deaths from heart disease each year.1
  • Between 1964 and 2014, 2.5 million people died from exposure to secondhand smoke, according to the 2014 report from the U.S. Surgeon General. The report also concluded that secondhand smoke is a definitive cause of stroke.1
  • There is no risk-free level of exposure to secondhand smoke and even short-term exposure potentially can increase the risk of heart attacks.2
  • Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide.2
  • Secondhand smoke can cause heart attacks; even relatively brief exposure can trigger a heart attack, according to a report by the Institute of Medicine.3

Secondhand Smoke in the Workplace

  • Secondhand smoke costs our economy $5.6 billion per year due to lost productivity.1
  • The health of nonsmokers exposed to secondhand smoke at work is at increased risk. Levels of secondhand smoke in restaurants and bars were found to be 2-5 times higher than in residences with smokers, and  2-6 times higher than in office workplaces.4
  • Being employed in a workplace where smoking is prohibited is associated with a reduction in the number of cigarettes smoked per day and an increase in the success rate of smokers who are attempting to quit.5
  • Casino workers in particular are exposed to hazardous levels of toxic secondhand smoke at work, including tobacco-specific carcinogens that increased in their bodies as their work shifts progressed, according to a report from the National Institute for Occupational Safety and Health.6

Secondhand Smoke and Children

  • Secondhand smoke is especially harmful to young children. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year. It also causes 430 sudden infant death syndrome (SIDS) deaths in the U.S. annually.7
  • Secondhand smoke exposure may cause a buildup of fluid in the middle ear, resulting in 790,000 doctor's office visits per year, as well as more than 202,000 asthma flare-ups among children each year.7
  • More than 23 million, or about 35% of children in the U.S. have been exposed to secondhand smoke.8

Secondhand Smoke and Lung Cancer Patients

  • Data show that patients with non-small cell lung cancer (the most common type of lung cancer) who are exposed to secondhand smoke have worse outcomes.Including:
    • Reduced overall survival.
    • Reduced progression-free survival (the length of time during and after treatment when the cancer does not grow or spread).
    • Simply put: lung cancer patients exposed to secondhand smoke are more likely to die than patients not exposed.
  • Exposure to secondhand smoke makes it harder for lung cancer patients who smoke to quit smoking.10 Smoking during lung cancer treatment makes the treatment less effective.11,12

What about Thirdhand Smoke?

Thirdhand smoke occurs when cancer-causing residue from tobacco smoke sticks to surfaces such as carpets and walls. Residue lingers for weeks-to-months and can re-enter the air. Children and pets may be most vulnerable.

Learn about the American Lung Association's programs to help you or a loved one quit smoking, and join our advocacy efforts to reduce tobacco use and exposure to secondhand smoke. Visit or call the Lung HelpLine at 1-800-LUNGUSA (1-800-586-4872).

  • What is Secondhand Aerosol from E-Cigarettes?

  • What is Secondhand Smoke?

  • What is Thirdhand Smoke?

  1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. 2014.

  2. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. 2006.

  3. Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington, DC: The National Academies Press. 2009.

  4. U.S. Department of Health and Human Services. Report on Carcinogens, Tenth Edition 2002. National Toxicology Program.

  5. National Cancer Institute. Population Based Smoking Cessation: Proceedings of a Conference on What Works to Influence Cessation in the General Population, Smoking and Tobacco Control Monograph 12. NIH Pub. 00-4892, Nov. 2000.

  6. National Institute for Occupational Health and Safety. Environmental and Biological Assessment of Environmental Tobacco Smoke among Casino Dealers, May 2009.

  7. California Environmental Protection Agency. Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Executive Summary. June 2005.

  8. Centers for Disease Control and Prevention. Exposure to Secondhand Smoke Among Nonsmokers — United States, 1988-2014. Morbidity and Mortality Weekly Report. December 7, 2018; 67(48):1342-6.

  9. Zhou W, Heist RS, Liu G, et al. Secondhand smoke exposure and survival in early-stage non-small cell lung cancer patients. Clin Cancer Res 2006;12:7187–93.

  10. Eng, et al. Second-Hand Smoke As a Predictor of Smoking Cessation Among Lung Cancer Survivors. 2014, doi: 10.1200/JCO.2013.50.9695

  11. Gemine R and Lewis K. Smoking Cessation with Lung Cancer: Not Too Little, Never Too Late! EMJ Respir. 2016;4[1]:86-91.

  12. Parsons A, et al. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ 2010;340:b5569. doi:10.1136/bmj.b5569

Page last updated: June 25, 2024

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