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Control of secondhand smoke exposure

Jonathan M Samet, MD, MS
Marianna Sockrider, MD, DrPH
Section Editors
George B Mallory, MD
Teresa K Duryea, MD
Deputy Editor
Alison G Hoppin, MD


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 [1]. 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:

(See "Secondhand smoke exposure: Effects in children".)

(See "Secondhand smoke exposure: Effects in adults".)

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Literature review current through: Nov 2017. | This topic last updated: Jun 29, 2016.
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