Smoke-free laws have been one of the most successful tobacco control measures. Many countries in the WHO European Region have comprehensive indoor clean air policies prohibiting smoking in public places like schools and healthcare facilities. Campaigns aim to denormalize smoking by asking smokers to smoke only outside and out of sight. It also helps them to reflect on their habits and to consider seeking professional help to quit.
While e-cigarettes do not produce tobacco smoke, their aerosols do contain nicotine and other chemicals that are harmful to others. The aerosols linger in the air longer than secondhand smoke, and even though it’s not smoke, it is still inhaled by bystanders. Secondhand vaping can cause breathing problems and other health issues for non-vapers, including infants, children, and adults with asthma. Reducing the risk of secondhand vape exposure is possible by not smoking around people with asthma or other respiratory conditions and not leaving a vaporizer in an area where someone else may inhale. However, a more permanent solution is to create a smoke-free environment. A policy that prohibits smoking in the home and car and restricts vaping to outdoor spaces like parks or restaurants can protect family members from secondhand vape and reduce the burden of respiratory symptoms. Several chemicals are present in the vapor created by e-cigarettes. It also emits nitrous oxide, a dangerous gas that can contribute to respiratory issues in the short term. In addition, the smoke can contain irritants like formaldehyde and acrolein that are emitted when certain ingredients in e-liquids are heated during vaping.
Electronic cigarette devices heat a liquid into an aerosol that the user inhales and exhales. This liquid can contain nicotine, glycerin, propylene glycol, flavoring chemicals and metals that may harm users. Nicotine is addictive and can cause dry mouth, coughing and phlegm buildup. It also can decrease blood flow and affect the brain development of young people, making it harder for them to concentrate and learn. Youth e-cigarette use has skyrocketed in recent years. A 2021 report from the National Youth Tobacco Survey found that among those aged 12-17, more than 2 million reported using e-cigarettes, and nearly 8 in 10 were using flavored products. There are several reasons e-cigarettes appeal to teens: they’re marketed as less dangerous than regular cigarettes, have lower per-use costs and offer more flavors. Several e-cigarette manufacturers have marketed their products in ways that are appealing to young people, including advertising their e-liquids as candy and food-based flavors. Some have even used models with young faces to promote their devices and e-cigarettes that look like popular foods. Some states regulate the time, place and manner e-cigarettes are sold or marketed.
Tobacco smoke contains:
- Toxic chemicals, including propylene glycol, are food additives used in antifreeze and paint solvents.
- Diethylene glycol is another such chemical.
- Heavy metals like nickel, tin and lead.
These are all inhaled into the lungs and can cause harm to adults and children alike. Secondhand smoke (SHS) exposure is a major health threat that affects nearly 1 in 3 adults worldwide and poses especially serious risks to children who have not yet fully developed lungs. Comprehensive smoke-free laws offer the most effective means of eliminating these dangers and ensuring people work, live, study, play, visit and eat in healthy environments. Smoke-free environments are important because tobacco and vape products cause third-hand exposure, which can occur when people ingest or breathe the residue left behind on surfaces. This residue can harm people of all ages but is especially dangerous to young children who crawl around and put everything in their mouths.
Many cities, states, workplaces, casinos and medical centers have switched to smoke-free environments. This move protects nonsmokers and helps prevent a costly shift in worker productivity, which can result from the lingering effects of secondhand smoke exposure. Tobacco production causes environmental damage, with research indicating that the industry contributes to climate change, the release of novel entities (toxic chemicals) and water use. Twenty-two billion liters of water are used along the tobacco supply chain each year, often in countries that don’t have safe drinking water.
Creating a Smoke-Free Environment
Making restaurants, workplaces, public parks and other spaces smoke-free has been a powerful strategy to limit secondhand smoke. It helps smokers quit or reduce their tobacco use, and it discourages people – especially youth – from starting to smoke. It also reduces employee sick days and medical costs and improves overall productivity. Earning a degree in public health is one way to make a difference in the lives of those exposed to secondhand smoke and help more spaces go smoke-free. Babies and children are especially vulnerable to secondhand smoke and vapor because their airways are smaller than adults and have less mature immune systems. In addition, e-cigarette aerosol may collect on indoor surfaces and produce harmful chemicals called toxic nitrosamines, leading to cancer and other serious illnesses.
Pediatricians should support clean air legislation and smoke-free environments in their communities and states, particularly outdoor areas where children often play. They should encourage parents and caregivers to create smoke-free homes and cars for their kids and encourage smokers to use nicotine replacement products outside, away from children, or to keep outdoor spaces smoke-free when they are in them. It will contribute to the first smoke-free generation and can set a new norm that makes it harder for kids to start smoking as adolescents.