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Passive Smoking

Dangers of Passive Smoking

  • Despite mounting global efforts to control tobacco use, tobacco smoking remains a common addiction with over 1 billion smokers in the world—about 40% of men and 10% of women.1 As a result, exposure to second-hand smoke, a known cause of morbidity and premature mortality, is widespread, occurring wherever people spend time in the presence of smokers.1 
  •  40% of children, 33% of nonsmokers, and 35% of female nonsmokers were exposed to secondhand smoke in 2004.1
  • Secondhand smoke is responsible for more than 603,000 deaths a year worldwide (around 1% of all deaths). 1 Of those deaths, 28% or  165,000 are children, 47% are women and 26% were men.1
  • 9 million years of good health (DALYs) were lost due to secondhand smoke exposure.1
  • Almost two-thirds of all deaths in children and adults and a quarter of DALYs attributable to exposure to second-hand smoke were caused by CAD in adult non-smokers.1
  • Non-smokers who breathe secondhand smoke (SHS) have between a 25% to 30% increase in risk of CAD.1 SHS interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of a cardiac event.1
  • There is a 30% excess risk of CAD in nonsmokers whose spouses smoke compared with that in nonsmokers whose spouses do not smoke.2
  • Even short exposures to SHS cause immediate changes that can lead to a CVD event.3 Short exposures to SHS can cause the blood to become stickier, damage the lining of blood vessels, alter the way the blood is pumped around the body, and alter the way the heart beats, potentially increasing the risk of a heart attack.1
  • Passive smoking is capable of precipitating acute manifestations of CVD.4 Exposure to SHS increases considerably the risk of recurrent events in patients who had survived a cardiac event.5
  • Homes and workplaces are the primary locations where nonsmokers are exposed to SHS, but exposure also occurs in public places such as restaurants and bars and in private vehicles.
  • At least 200,000 workers die every year due to exposure to SHS at work.
  • The increasing presence of restrictive workplace policies seems to be a component of a substantial decline in self-reported passive smoke exposure.6  These policies also appear to be encouraging smokers to quit.7


  • Around 700 million children, or almost half of the world’s children, breathe air polluted by tobacco smoke, particularly at home.1
  • Among students 13 to 15 years old in 132 countries 44% are exposed to SHS at home and 56% of the students are exposed to SHS in public places. 1
  • Almost 60% of US children aged 3–11 years—or almost 22 million children—are exposed to SHS.
  • In Argentina, 68 % of children are exposed to passive smoking at home. 1
  • Low- and middle-income countries saw the majority of child deaths resulting from secondhand smoke.1 In Africa, around 43,000 children died due to secondhand smoke exposure, compared to the 9,500 adults who died due to secondhand smoke exposure.1 Worldwide, children are more exposed to secondhand smoke than any other age group and are typically unable to avoid exposure.1
  • Second, exposure to secondhand smoke contributes to the death of thousands of children younger than 5 years in low-income countries. Prompt attention is needed to dispel the myth that developing countries can wait to deal with tobacco-related diseases until they have dealt with infectious diseases.”1


  • Exposure to SHS kills as many women in China as does smoking: 48,400 women in China died from lung cancer and CAD  attributed to passive smoking in 2002 compared with 47,300 lung cancer and heart disease deaths from “active” smoking.1
  • Women non-smokers have 62% more risk of stroke if their husbands’ smoke a pack of cigarettes a day, than women nonsmokers living with nonsmoking spouses.8
  • Among non-smoking women, exposure to environmental tobacco smoke is associated with a 15% increase in the risk of dying from heart disease compared with nonsmoking women not exposed to environmental tobacco smoke.9


1. Oberg M, Jaakkola MS, Woodward A, Peruga A, Pruss-Ustun A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. Nov 25 2010.

2. Law MR, Wald NJ. Environmental tobacco smoke and ischemic heart disease. Prog Cardiovasc Dis. Jul-Aug 2003;46(1):31-38.

3. Venn A, Britton J. Exposure to secondhand smoke and biomarkers of cardiovascular disease risk in never-smoking adults. Circulation. Feb 27 2007;115(8):990-995.

4. Raupach T, Schafer K, Konstantinides S, Andreas S. Secondhand smoke as an acute threat for the cardiovascular system: a change in paradigm. Eur Heart J. Feb 2006;27(4):386-392.

5. Panagiotakos DB, Pitsavos C, Stefanadis C. Chronic exposure to second hand smoke and 30-day prognosis of patients hospitalised with acute coronary syndromes: the Greek study of acute coronary syndromes. Heart (British Cardiac Society). Mar 2007;93(3):309-312.

6. Widome R, Jacobs DR, Jr., Schreiner PJ, Iribarren C. Passive smoke exposure trends and workplace policy in the Coronary Artery Risk Development in Young Adults (CARDIA) study (1985-2001). Preventive medicine. Jun 2007;44(6):490-495.

7. Hammond D, Fong GT, Zanna MP, Thrasher JF, Borland R. Tobacco denormalization and industry beliefs among smokers from four countries. Am J Prev Med. Sep 2006;31(3):225-232.

8. Zhang X, Shu XO, Yang G, et al. Association of passive smoking by husbands with prevalence of stroke among Chinese women nonsmokers. Am J Epidemiol. Feb 1 2005;161(3):213-218.

9. Kaur S, Cohen A, Dolor R, Coffman CJ, Bastian LA. The impact of environmental tobacco smoke on women’s risk of dying from heart disease: a meta-analysis. Journal of women’s health (2002). Oct 2004;13(8):888-897.

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