Whether it’s the lingering haze on your morning commute or the casual smoke drifting across an outdoor café, passive exposure to smoke poses a daily health risk to millions.
A study published in The Lancet Public Health earlier in September estimates that 3,25,600 people in India died from causes attributable to exposure to second-hand (passive) smoke in 2023, up from 2,17,700 in 1990, a rise of nearly 50% over 33 years. The study estimates that around 444 million Indians were exposed to second-hand smoke in 2023, up from 375 million in 1990.
The health burden extends beyond deaths. The study estimates that second-hand smoke accounted for 9.28 million disability-adjusted life years in India in 2023. This suggests that healthy years lost to premature death, illness or disability is a reminder that not smoking simply isn’t always enough to avoid the health risks associated with tobacco smoke.
“Even short-term exposure to tobacco smoke can irritate the eyes, throat and lungs. It can even temporarily affect blood vessels and heart function,” says respiratory disease and sleep medicine specialist Dr Shweta Bansal, Artemis Hospital, Gurugram.
One may think spending ten minutes around a smoker may be harmless. But Dr Bansal says, “During those minutes you can breathe in tobacco smoke, which contains fine particles, nicotine and cancer-causing chemicals. Children, pregnant women, older adults and asthmatic people may be particularly vulnerable. It’s safer to avoid exposure altogether.”
What actually helps reduce smoke exposure?
“If someone around you smokes, the most effective step is to move away from the smoke rather than trying to ventilate it,” says thoracic oncosurgeon Dr L.M. Darlong, Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), New Delhi. He suggests ways like not smoking inside the home or car, and if the person continues to smoke, asking them politely to move outdoors might help.
Can a fan or another room keep the smoke away?
{{/usCountry}}“If someone around you smokes, the most effective step is to move away from the smoke rather than trying to ventilate it,” says thoracic oncosurgeon Dr L.M. Darlong, Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), New Delhi. He suggests ways like not smoking inside the home or car, and if the person continues to smoke, asking them politely to move outdoors might help.
Can a fan or another room keep the smoke away?
{{/usCountry}}“Opening a window, switching on an exhaust fan or moving the smoker to another room may reduce smoke, but cannot eliminate exposure. Ventilation can lower concentrations but cannot be depended upon to remove all harmful substances,” asserts Dr Bansal.
Do air purifiers and nasal filters work?
The market has gadgets like nasal filters that fit inside your nostrils to block airborne particles, and air purifiers with a High-Efficiency Particulate Air (HEPA) filter and thick activated carbon filter. But do they make indoor smoking safe?
“A HEPA air purifier may reduce some particles, especially when paired with activated carbon, but it cannot eliminate second-hand smoke,” says Dr Darlong. The expert urges people to treat a purifier as additional support, not permission to smoke indoors.
He continues, “The same applies to nasal filters. They are not reliable protection because cigarette smoke contains both fine particles and harmful gases.”
How to avoid passive smoking in a social setting
At an office party, after-work gathering or dinner with friends, asking someone not to smoke can feel awkward, especially when everyone else is standing around chatting. But here are ways to navigate it politely:
- If standing next to someone who is smoking, move farther away and, where possible, stand upwind
- You can always say, ‘I’m sensitive to smoke, so I’m going to step outside’ or ‘Smoke triggers my throat, so I’ll stand over there’
- Non-smokers can choose smoke-free seating and venues
The side effects of third-hand smoke
Beyond second-hand smoke, there’s third-hand smoke, the tobacco residue that lingers after smoking. This is caused by tobacco chemicals and toxic particles that can settle on clothes, carpets, curtains, furniture and other surfaces.
“Repeated smoking indoors can cause a buildup of nicotine and other harmful substances, which may react with indoor pollutants to create more toxic compounds,” says pulmonologist Dr Neeraj Gupta, Marengo Asia Hospitals, Gurugram.
This is particularly relevant for children. He continues, “Children are particularly vulnerable because they touch surfaces, crawl on the floor and often put their hands in their mouths. Smoke residue can also cling to a smoker’s hair and clothes and be carried indoors.”
Dr Darlong says, “Fans, air-conditioners and open windows may reduce the concentration or smell of smoke, but they cannot remove the health risk. Room fresheners only mask the smell.”