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Secondhand smoke is a major cause of disease, including lung cancer and coronary heart disease, in nonsmokers.

Many millions of adults are exposed to secondhand tobacco smoke in their homes and workplaces despite substantial progress in tobacco control. Levels of cotinine, a biomarker of secondhand tobacco smoke exposure, fell by 24% from 1999-2000 to 2007-2008 among nonsmokers aged 3+ years in the United States, however, 40% of nonsmokers aged 3+ years still have detectable levels of cotinine. Nonsmokers who are exposed to secondhand smoke inhale many of the same cancer-causing chemicals that smokers inhale. Secondhand tobacco smoke is composed of sidestream smoke (the smoke released from the burning end of a cigarette) and exhaled mainstream smoke (the smoke exhaled by the smoker). Secondhand  tobacco smoke contains more than 7000 chemical compounds including many of the same chemicals that are present in the smoke inhaled by smokers. Because sidestream smoke is generated at lower temperatures and under different conditions than mainstream smoke, it contains higher concentrations of many of the toxicants found in mainstream smoke. The National Toxicology Program estimates that at least 250 chemicals in secondhand tobacco smoke are known to be toxic or carcinogenic, cancer-causing agents. It is estimated that secondhand smoke kills more than 600,000 people worldwide every year.

CDC. Vital Signs: Nonsmokers’ exposure to secondhand smoke – United States, 1999-2008. Morb Mortal Wkly Rep. 2010; 59: 1141-1146.

Shafey O, Eriksen M, Ross H, Mackay J
. The Tobacco Atlas. American Cancer Society.

Oberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011; 377(9760): 139-146.

U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. logo
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