Healthy Homes

Environmental Health and Tobacco

Tobacco use causes 20% of cancer deaths worldwide, and it is estimated that tobacco-related deaths will result in 10-million deaths annually by 2020. We've come a long way since the mid-1900's in understanding the negative health effects of tobacco to smokers.

Health Effects

• Tobaccos smoke contains more than 7,000 chemicals. Hundreds are toxic and about 69 can cause cancer. 
• Smoking is the leading cause of preventable death in the U.S. and causes over 438,000 deaths per year.
• Secondhand smoke causes 41,000 deaths in the U.S. each year from heart disease and lung cancer.
• While smoking is on the decline for both adults and students, there is still work to be done.

What Environmental Health Professionals are Doing

Environmental Health professionals conduct a variety of activities to control tobacco exposure, such as:

• Investigate - Complaints and sample environments that may have unhealthy levels.
• Enforce - Many municipalities across the county prohibit smoking in public places, so EH professionals enforce local codes, ordinances, and statutes restricting tobacco use. While there are not well-established exposure limits for tobacco smoke, there are many exposure limits for specific chemicals within tobacco smoke. Some of these chemicals have exposure limits for occupational settings.
• Educate - Environmental Health agencies provide many educational resources and programs in awareness and tobacco cessation. They spearhead health campaigns to prevent illness and injury. Read about what local environmental health agencies are doing for their communities. 

Emerging Issues

• Third-Hand Smoke

NEHA Resources

• World Environmental Health Day - Celebrate with NEHA on September 26, 2016. This year's theme is tobacco control and NEHA is focusing specifically on the negative health effects of second and third hand smoke to both individuals and societies. Help us raise awareness of the environmental health implications of tobacco use. 

• Third-Hand Smoke

• Second Hand Smoke
• Tobacco and EH Professionals

Additional Resources

American Public Health Association (APHA)

• Webpage:Tobacco 
• Infographic: Live Tobacco Free Infographic
• Policy Statement: Reducing the Rising Rates of Asthma
• Policy Statement: Tobacco Free School Environments
• Policy Statement: Smoke Free Indoor Air   
• Policy Statement: Supporting Regulation of E-Cigarettes   
   

Centers for Disease Control (CDC) in conjunction with U.S. Environmental Protection Agency  (EPA)

• Fact Sheet: Tobacco Fact Sheet  
• Fact Sheet: Tobacco Use and Secondhand Smoke Exposure is High in Multiunit Housing
   

Green and Healthy Homes Initiative

• Webpage: Tobacco Resource Page 

National Association of County and City Health Officials (NACCHO)

• Factsheets:
  
  • Documentation Considerations for Accreditation: Tobacco Prevention and Control
  • Local Public Health Policy on Electronic Smoking Devices
• Guide: Best Practices for Comprehensive Tobacco Control Programs at the Local Level
• Impact Stories: Tobacco Prevention and Control Stories from the Field
• Policy Statement: Indoor Air Quality and Public Health
• Report: Building Healthy Communities: Action Planning for Tobacco Prevention and Control
• Webinars:
  
  • Creating and Enforcing Smoke-Free Multiunit Housing
  • Creating and Enforcing Tobacco-Free Environments at Colleges and Universities
  • How State and Local Health Departments Can Leverage CDC’s 2015 Tips Campaign

Second Hand Smoke 

Second hand smoke occurs when someone uses and exhales tobacco products such as cigarettes, cigars, or pipes, and the smoke is then inhaled involuntarily by others.

Health Effects

• Tobacco smoke contains more than 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer.
• Since 1964 it is estimated that 2.5 million deaths are attributed in the U.S. to health problems caused by exposure to secondhand smoke.

The Hidden Hazard of Third Hand Smoke

Tobacco use causes 20% of cancer deaths worldwide, and it is estimated that tobacco-related deaths will result in 10-million deaths annually by 2020. We've come a long way since the mid-1900's in understanding the negative health effects of tobacco to smokers.

More recently, we've learned that second hand smoke also has deleterious consequences for those who are exposed to it. Yet, the concept of third hand smoke goes largely unnoticed even though a study in 1953 first identified the problem.

What is third hand smoke?

• Third hand smoke is nicotine residue that remains on surfaces including walls, doors, drapery, carpets, clothes, furniture, flooring material, and acoustic tiles in ceilings. This pollutant also can be inhaled when it is re-emitted through dust in the air, and it can react with substances in the environment to create secondary pollutants on surfaces.
• People, especially seniors and children, and pets are affected by this under-appreciated health hazard through skin exposure, dust inhalation and ingestion.
• Some chemicals* found in third hand smoke are:
  -hydrogen cyanide (used in chemical weapons)
  -butane (used in lighter fluid)
  -toluene (found in paint thinners)
  -arsenic
  -lead
  -carbon monoxide
  -polonium-210, a highly radioactive carcinogen
• Research demonstrates that tobacco smoke is a toxic substance with no safe level of exposure, and that the risks from exposure are largely dose related.

*Visit the CDC’s Agency for Toxic Substances and Disease Registry for information on health risks associated with these chemicals. 

Who is affected by third hand smoke?

• Third hand smoke affects people who live in homes, hotels, or any indoor environment that was used long term by smokers. Even cars used by smokers can have third hand smoke residue.

• Babies, toddlers, and children are at greater risk of negative health effects because:

1) they inhale 40 times more than adults

2) they have greater hand/object/mouth contact so they absorb proportionately more through ingestion

3) have greater absorption through their skin

• Data show that individuals classified as low socio-economic status tend to live in more multi-unit housing where smoking may not be banned.
  If your neighbor smokes, it can get into your apartment through the ventilation system.
  Third hand smoke can be present in apartments even if they have been vacant for two months and are cleaned and prepared for new residents.

How can Environmental Health professionals help?

Third hand smoke is part of an individual’s built environment, which often they have little control over. Environmental health professionals seek to protect people against environmental factors that may adversely impact human health; they are instrumental in enforcing regulations and providing health education to limit third hand smoke exposure and associated disease outcomes.

Learn more about Tobacco and EH Professionals

Why have I never heard about third hand smoke before?

It took decades to develop the proponderance of evidence and prove that smoking causes lung cancer and a multitude of other adverse health effects. It took additional years to prove second hand smoke also kills.
It was only recently that scientists identified third hand smoke from tobacco combustion lingering on clothing, bedding, carpeting and furniture and attributed their contribution to adverse health effects.

What can be done to limit exposure of third hand smoke?

A 2010 study indicated that third-hand smoke accumulates in smokers' homes and persists even after homes have been vacant for two months and are cleaned and prepared for new residents.
This study also indicates that there is not much that can be done in terms of cleaning third hand smoke in affected places. Recommendations to minimize potential negative health effects are:

• Avoid any indoor environment that was used long-term by smokers.
• Insist that smokers go outdoors and do not smoke in homes or in cars.
• Support smoking bans and enforcement of them.
• In homes with long term smoke exposure consider replacing carpets, ventilation systems, furniture, etc.

While research needs to be done on how to clean up third hand smoke, it is best to simply avoid any indoor environment that was used long-term by smokers.

Smoke Free Places in the U.S.

To find local ordinances, maps, and resources for smoke-free venues, visit No-Smoke.org. 

Many of the following indoor places in the U.S. have become smoke free:

• Hospitals
• Nursing Homes
• Colleges and Universities
• Correctional facilities
• Hotels/motels
• Airports
• Major League Baseball, National Football League stadiums
• Multi-Unit housing
• Casinos and Gambling Facilities
• Pharmacies (CVS)
• Bars and restaurants
• Workplaces

Many outdoor areas are becoming smoke free in the U.S. as well, such as:

• Beaches
• Public Transit spaces
• Parks and zoos
• Outdoor patios

Maps at http://www.no-smoke.org/goingsmokefree.php?id=519#maps

Tobacco and Environmental Health Implications

Tobacco use causes 20% of cancer deaths worldwide, and it is estimated that tobacco-related deaths will result in 10-million deaths annually by 2020. We've come a long way since the mid-1900's in understanding the negative health effects of tobacco.  

NEHA celebrated World Environmental Health Day on September 26, along with the International Federation of Environmental Health (IFEH) and many other organizations to shed light on the important work of environmental health around the world. This year's theme is tobacco control and NEHA is focusing specifically on the negative health effects of second and third hand smoke to individuals and societies.
 
We invite you to raise awareness of World EH Day and the environmental health implications of the growth, sale, and use of tobacco products.

Learn More Tobacco and Environmental Health Implications

• Environmental Health and Tobacco
• Second Hand Smoke
• Third Hand Smoke
• Tobacco and EH Professionals 

World EH Day Toolkit

Check out our toolkit for World EH Day resources you can use to help spread the word to others.