Control of secondhand smoke exposure
- Jonathan M Samet, MD, MS
Jonathan M Samet, MD, MS
- Professor and Flora L. Thornton Chair, Department of Preventive Medicine
- Keck School of Medicine, University of Southern California
- Marianna Sockrider, MD, DrPH
Marianna Sockrider, MD, DrPH
- Associate Professor of Pediatric Pulmonology
- Baylor College of Medicine
- Section Editors
- George B Mallory, MD
George B Mallory, MD
- Section Editor — Pediatric Pulmonology
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Teresa K Duryea, MD
Teresa K Duryea, MD
- Section Editor — General Pediatrics
- Associate Professor of Pediatrics
- Baylor College of Medicine
Exposure to secondhand smoke (SHS) takes place in many different microenvironments (ie, distinct places where time is spent). The contributions of various microenvironments to personal SHS exposures depend upon the amount of time spent in each setting, and on the concentrations of SHS in those environments. The contributions of different microenvironments also depend upon age, sex, and other sociodemographic factors that determine time-activity patterns. For children, the home is a dominant locus of exposure, whereas for adults the workplace and social environments may be significant loci, depending on coverage by clean indoor air regulations and laws.
The concentration of SHS in a particular indoor environment depends upon the intensity of smoking (the strength of the source), the rate of exchange of air in the space with outdoor air or other "clean" air, and the presence and effectiveness of any air cleaning devices. For public and commercial buildings, ventilation requirements are set by code, generally following the standards published by the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE). The ventilation standard assumes that adequate indoor air quality cannot be achieved if smoking is allowed, even with additional ventilation, a view reaffirmed in a position statement by ASHRAE . Air cleaning also is not sufficient if smoking is allowed. Elimination of smoking in an environment appears to be the only effective means of preventing SHS exposure in that location [2-4].
Strategies to prevent SHS exposure and the role of the healthcare provider are reviewed here. The adverse health effects of SHS and related issues are discussed separately:
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- STRATEGIES TO PREVENT SECONDHAND SMOKE EXPOSURE
- Recommendations of the Task Force on Community Preventive Services
- Air cleaners
- THE ROLE OF THE HEALTH CARE PROVIDER
- Support for smoking cessation
- THE HOME ENVIRONMENT
- Effect of smoking bans
- Third-hand smoke exposure
- Electronic cigarette secondhand vapor exposure
- PUBLIC SMOKING BANS
- Public places and transportation environments
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS