Secondhand Smoke and Cancer
Secondhand smoke, or Environmental Tobacco Smoke (ETS), is the combination of two forms of smoke from burning tobacco products:

1. Sidestream smoke, or smoke that is emitted between the puffs of a burning cigarette, pipe, or cigar, and

2. Mainstream smoke, or the smoke that is exhaled by the smoker.

When a cigarette is smoked, about half of the smoke generated is sidestream smoke, which contains essentially the same compounds as those identified in the mainstream smoke inhaled by the smoker. Some of the chemicals in secondhand smoke include substances that irritate the lining of the lung and other tissues, carcinogens (cancer-causing compounds), mutagens (substances that promote genetic changes in the cell), and developmental toxicants (substances that interfere with normal cell development). Tobacco smoke is known to contain at least 60 carcinogens, including formaldehyde and benzo[a]pyrene, and six developmental toxicants, including nicotine and carbon monoxide.

Nonsmokers who are exposed to secondhand smoke absorb nicotine and other compounds just as smokers do. As the exposure to secondhand smoke increases, the levels of these harmful substances in the body increase as well. Although the smoke to which a nonsmoker is exposed is less concentrated than that inhaled by smokers, research has demonstrated significant health risks associated with secondhand smoke.

Health Problems Associated With Secondhand Smoke Exposure:

Research conducted by the U.S. Surgeon General and the National Research Council of the National Academy of Sciences has shown that:

• Secondhand smoke can cause lung cancer in healthy adult nonsmokers.
Scientists estimate that secondhand smoke is responsible for approximately 3,000 lung cancer deaths per year among nonsmokers in the United States. Recent studies point to a 20 percent increased risk of lung cancer in nonsmokers due to secondhand smoke.

• Children of parents who smoke have more respiratory symptoms and acute lower respiratory tract infections, as well as evidence of reduced lung function, than do children of nonsmoking parents; and

• Separating smokers and nonsmokers within the same air space may reduce but does not eliminate a nonsmoker's exposure to secondhand smoke.

Developmental Effects of Secondhand Smoke:


• Low birth weight or small for gestational age

• Sudden Infant Death Syndrome (SIDS)

Respiratory Effects of Secondhand Smoke:

• Acute lower respiratory tract infections in children


• Asthma induction and exacerbation in children

• Chronic respiratory symptoms in children

• Eye and nasal irritation in adults

• Middle ear infections in children

Carcinogenic Effects of Secondhand Smoke: 

• Lung Cancer

• Nasal Sinus Cancer

Cardiovascular Effects of Secondhand Smoke: 


• Heart disease mortality

• Acute and chronic coronary heart disease morbidity

Other health effects that were found to be possibly associated with secondhand smoke exposure were as follows:

• Spontaneous abortion (miscarriage);

• Adverse impact on cognition and behavior during child development;

• Exacerbation of cystic fibrosis (a disease marked by overproduction of mucus in the lungs);

• Decreased lung function; and

• Cervical cancer.

However, further research is needed to confirm the link between these health risks and secondhand smoke.


Related Topics:

Cigarette Smoking and Cancer

Cigar Smoking and Cancer


Smokeless Tobacco and Cancer

Benefits of Quitting Smoking

Methods of Quitting Smoking


Source: U.S. National Cancer Institute
This fact sheet describes how secondhand smoke, also known as Environmental Tobacco Smoke (ETS), can increase the risk of cancer and other health problems for nonsmokers. Children living with smokers are especially at risk. You can learn more about the dangers of smoking and tobacco use via the links at the bottom of this page.

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