American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Clearing the Air: The Facts About Secondhand Smoke

Young man lighting a cigaretteAs the summer sunshine invites many Americans to spend added time outdoors and in public places, few may fear the well-known health hazard that awaits them. Couples dining al fresco or families playing in the park, fall prey to a stranger’s hovering secondhand smoke.  

“While smoking is the leading preventable cause of death in the United States,” explains Kitturah Klaiss, DO, an osteopathic family physician from West Blockton, Alabama, "secondhand smoke is the third, so it is a very serious health threat.” 

Secondhand smoke (SHS) is also known as passive, involuntary or environmental tobacco smoke (ETS). The fumes are a mixture of particles from the burning end of a cigarette, cigar, or pipe and the smoke breathed out by the smoker. There are two types of SHS, mainstream and sidestream smoke. 

Doctors of Osteopathic Medicine, or DOs, look beyond your symptoms to understand how lifestyle and environmental factors affect your wellbeing. They listen and partner with you to help you get healthy and stay well. They also encourage your body’s natural tendency toward self-healing.

Smoking Facts

“Mainstream smoke is exhaled from the lungs of the smoker,” clarifies Dr. Klaiss. “The more toxic of the two, sidestream smoke, is released from the burning end of cigarette.” 

Mainstream smoke has less concentration of toxic chemicals because tobacco burns cleaner at the high temperatures created when a smoker inhales. On the other hand, sidestream smoke burns at a lower temperature and without the cigarette filter that screens some of the toxins for the smoker when inhaling. As a result, sidestream smoke emits five times the amount of carbon monoxide; three times the amount of cancer-causing benzopyrene; and 50 times the amount of ammonia found in mainstream smoke.

Secondhand smoke contains more than 4,000 chemicals and 200 poisons, including 69 carcinogens,” explains Dr. Klaiss. “It can take up to two weeks for nicotine alone to clear from the air in a room where smoking has occurred.” 

Even as the cost of cigarettes continues to increase and cigarette manufacturers post tips on their websites educating consumers about the health risks, a staggering 44 million men and women in the United States continue to smoke. Furthermore, according to the Centers for Disease Control and Prevention, more than 440,000 smoking-related deaths occur annually, of which roughly 50,000 are caused by SHS 

“Secondhand smoke speeds hardening of the arteries; can cause blood to clot; and arterial linings to be damaged,” explains Dr. Klaiss. “The carbon monoxide inhaled from secondhand smoke limits the amount of oxygen that reaches the heart muscles, a cause of heart attacks and strokes.”  

Avoiding Secondhand Smoke

To avoid SHS, Dr. Klaiss suggests these tips:

  • Avoid public places where people are smoking.

  • If you're at a restaurant, hotel or other establishment that allows smoking, request a “nonsmoking” option. Most states have smoke-free Web sites with non-smoking establishment listings.

  • If a restaurant puts you near smokers, ask to be moved.

  • If smokers do not obey nonsmoking rules, politely ask that they not smoke around you.

  • Do not allow smokers to smoke around your children.

  • Ask visitors not to smoke in your home.

  • If you live with smokers, encourage them to quit.

“Lack of toleration when it comes to secondhand smoke can help reinforce the need for smokers to quit,” explains Dr. Klaiss. “A healthy lifestyle does not include first or secondhand smoke.” ​​​​


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