Smoking in the Home

Quitting smoking can significantly decrease your child’s chances of starting to smoke.1

In a household where adults smoke, children are exposed to the smoke.
No amount of exposure to tobacco smoke is considered safe.
The best way to keep your children safe from the harmful effects of smoking is to quit smoking.

What is tobacco smoke?

Tobacco smoke is produced from products such as cigarettes and cigars. One way in which children are exposed to this type of smoke is through secondhand smoke, or environmental tobacco smoke.  Secondhand smoke exposure means that they breathe in the smoke that is exhaled by people who smoke or that is released by a burning cigarette or cigar. Secondhand smoke contains over 4,000 substances, and these can be harmful to children’s health.2 

Children can also be exposed to harmful substances through thirdhand smoke, or smoke residue. Thirdhand smoke occurs when secondhand smoke settles on surfaces like floors, furniture, walls, and clothes. It later can be re-breathed in, absorbed by contact through the skin, or ingested through hand-to-mouth behaviors. This type of smoke contains nicotine and other chemicals that can have harmful effects on children’s health. The American Academy of Pediatrics warns about its harms.3

Children may also be exposed to tobacco smoke from outside the home. Smoke incursion means that smoke comes into the home through doors, windows, or cracks, or from outside, like from a neighbor’s home. This is more likely to happen if you live in a building with multiple units that are close together.

There are no safe levels of exposure to smoke. Children exposed to secondhand smoke are at a higher risk for a number of health problems.3 These can include pneumonia, bronchitis, and middle ear infections. Secondhand smoke can also make children’s asthma worse and slow lung growth. Infants exposed to secondhand smoke have an increased risk of sudden infant death syndrome (SIDS). Secondhand smoke can also be breathed in by pregnant people, leading to complications like low birth weight in newborns and developmental issues as children get older.

Young children are especially vulnerable to thirdhand smoke. Crawling, mouthing, and playing near surfaces that have smoke residue can expose them to the chemicals within smoke.  Secondhand and thirdhand smoke can contain all of the same harmful chemicals that people who smoke are exposed to. Exposure to secondhand smoke can cause lung cancer and a higher risk of heart disease even in people who do not smoke.

Smoking in the home can influence children’s future smoking habits and behaviors. Children of people who smoke are over two times as likely to start smoking daily between the ages of 13 and 21.4 However, if parents quit smoking, especially before their child is in the third grade, the chances of their child picking up smoking are much lower.1 Keeping your home smoke-free not only impacts your child’s immediate health but also helps prevent them from smoking in the future.5

Tobacco products, such as cigarettes and cigars, are not the only products that produce potentially dangerous smoke. Marijuana products, e-cigarettes, and vapes can have potential risks too.  

Smoke from marijuana products contains many of the same toxic and cancer-causing chemicals as tobacco smoke. More research is needed, but it is thought that secondhand marijuana smoke has a similar risk as secondhand tobacco smoke.6 Secondhand marijuana smoke also includes levels of tetrahydrocannabinol (THC) that may cause harmful effects in children.7 Even among parents who reported only smoking marijuana outside the home, one third of their children had detectable levels of THC in their blood.8

While E-cigarettes and vaping products do not produce smoke, they release chemicals, also known as aerosols, into the air. We are still learning about the health risks of these aerosols, and we currently know that exposure to them (especially in children) can still cause harm.9  Health risks include respiratory problems, heart problems, and potentially cancer.10 Research also shows that secondhand exposure to these products can lead to respiratory symptoms and decrease home air quality.11,12 Further research is needed to fully understand the risk of these products to children’s health. These products are sometimes marketed using colors and flavors that appeal to children. It is important to discuss the harms of these products, and tobacco in general, with your children.5,13

If you can smell smoke, then you and your family are being exposed to secondhand or thirdhand smoke. There is typically no need for additional environmental testing. Other signs of previous smoke exposure in a room include yellow-brown discoloration on walls or ceilings and objects or a somewhat sticky residue where tobacco smoke has settled. 

Commercial tests are available for secondhand tobacco smoke testing, but they are often expensive and/or not able to detect small amounts of secondhand and thirdhand smoke that may still be harmful to children’s health. For more information about commercial testing, the Thirdhand Smoke Resource Center in California has compiled a list of available options.

A good rule of thumb is that if you see signs of smoking or if you smell smoke, that is good enough to know you should clean the space. Hard surfaces like walls, tables, and floors and soft surfaces like clothing, upholstery, and bedding with notable residue should be cleaned with a regular household cleaner (see the Resources section below for information on cleaning your home safely).

During a doctor’s visit, pediatricians evaluate smoke exposure through questionnaires and parent reporting. A urine test (the cotinine test) that indicates smoke exposure is available, but this is mainly used in research, not in a clinical setting.  One reason it is not typically used by pediatricians in the clinic is that we do not know exactly how test levels match with potential health effects. The test also cannot tell us where the exposure is coming from or otherwise guide clinical management. If you have concerns, however, you can discuss them with your child’s pediatrician.

By far, the best way to prevent exposure to secondhand and thirdhand smoke is to stop all smoking! If you or someone you love is interested in quitting smoking, New York State has resources to help. Quitting smoking can be challenging but many people succeed and quit permanently. If quitting is not possible at this time, you should limit your children’s smoke exposure. This can be done by not smoking inside the home or car.  If you have been smoking outside, change your clothes before getting close to your child or other loved one.  

If your home is exposed to smoke from neighbors, you can reduce secondhand smoke incursion by doing things such as sealing cracks in floors or walls with low odor caulking, using weather stripping under the doors, and increasing ventilation by opening windows. If you are experiencing smoke incursion in your home, the Public Health Law Center has produced a guide specific to New York State that explains your rights and options. 

If there is ongoing secondhand smoke in the home, ventilation and air filtration may help reduce exposure. Neither of these options can fully eliminate the risks.14 Portable high efficiency particulate air (HEPA) filters as well as furnace/HVAC filters can remove larger particles of secondhand smoke but do not eliminate risks from smaller particles or gasses. They also can be costly. For more information on air filters and ventilation see this guide produced by the Centers for Disease Control and Prevention (CDC). For more information on air filters in the home, see this guide produced by the Environmental Protection Agency (EPA).

Additionally, if there is a history of smoking in the home you can reduce exposure to old smoking residue by cleaning hard surfaces like walls, tables, and floors as well as washing soft surfaces like clothing, upholstery, and bedding using regular household cleaners. See the resources for more information on safely cleaning your home.

  Prescriptions for Prevention 

Featured Rxs – English:
Indoor Air, Secondhand Smoke, Vaping and E-Cigarettes, Smoking, Marijuana, Safer Disinfecting in Your Home, Green Cleaning

Featured Rxs – Español:
Calidad del Aire Interior, Humo de Segunda Mano, Cigarrillos Electrónicos, Tabaquismo, Marihuana, Desinfección mas segura, Limpieza ecológica

 

National and Statewide Resources

Albany – Capital Region:

Buffalo:

Hudson Valley:

New York City:  

Rochester:

Syracuse:

  1. Wyszynski CM, Bricker JB, Comstock BA. Parental smoking cessation and child daily smoking: A 9-year longitudinal study of mediation by child cognitions about smoking. Health Psychol. Mar 2011;30(2):171-6. doi:10.1037/a0022024
  2. Leone A. Biochemical markers of cardiovascular damage from tobacco smoke. Curr Pharm Des. 2005;11(17):2199-208. doi:10.2174/1381612054367391
  3. The Dangers of Secondhand Smoke. Healthychildren.org from the American Academy of Pediatrics. Accessed August 29, 2024. https://www.healthychildren.org/English/health-issues/conditions/tobacco/Pages/Dangers-of-Secondhand-Smoke.aspx
  4. Kandel DB, Griesler PC, Hu MC. Intergenerational Patterns of Smoking and Nicotine Dependence Among US Adolescents. Am J Public Health. Nov 2015;105(11):e63-72. doi:10.2105/AJPH.2015.302775
  5. Jenssen B. Protecting Kids from Tobacco’s Harms: AAP Policy Explained. healthychildren.org from the American Academy of Pediatrics. Accessed August 29, 2024. https://www.healthychildren.org/English/health-issues/conditions/tobacco/Pages/AAP-Recommendations-on-Tobacco-E-Cigarettes.aspx
  6. Moir D, Rickert WS, Levasseur G, et al. A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two machine smoking conditions. Chem Res Toxicol. Feb 2008;21(2):494-502. doi:10.1021/tx700275p
  7. Holitzki H, Dowsett LE, Spackman E, Noseworthy T, Clement F. Health effects of exposure to second- and third-hand marijuana smoke: a systematic review. CMAJ Open. Nov 24 2017;5(4):E814-E822. doi:10.9778/cmajo.20170112
  8. Wilson KM, Torok MR, Wei B, et al. Detecting biomarkers of secondhand marijuana smoke in young children. Pediatr Res. Apr 2017;81(4):589-592. doi:10.1038/pr.2016.261
  9. In: Eaton DL, Kwan LY, Stratton K, eds. Public Health Consequences of E-Cigarettes. 2018.
  10. Yammine L, Tovar M, Yammine NA, Becker C, Weaver MF. E-cigarettes and Youth: The Known, the Unknown, and Implications for Stakeholders. J Addict Med. Jul-Aug 01 2024;18(4):360-365. doi:10.1097/ADM.0000000000001304
  11. Islam T, Braymiller J, Eckel SP, et al. Secondhand nicotine vaping at home and respiratory symptoms in young adults. Thorax. Jul 2022;77(7):663-668. doi:10.1136/thoraxjnl-2021-217041
  12. Shearston JA, Eazor J, Lee L, et al. Effects of electronic cigarettes and hookah (waterpipe) use on home air quality. Tob Control. Jan 2023;32(1):36-41. doi:10.1136/tobaccocontrol-2020-056437
  13. E-Cigarettes & Vaping: Facts for Parents. healthychildren.org from the American Academy of Pediatrics. Accessed August 29, 2024. https://www.healthychildren.org/English/health-issues/conditions/tobacco/Pages/Facts-For-Parents-About-E-Cigarettes-Electronic-Nicotine-Delivery-Systems.aspx
  14. American Society of Heating RaA-CEA. ASHRAE Position Document on Environmental Tobacco Smoke. Atlanta: ASHRAE, 2010. 2010. https://www.ashrae.org/about/position-documents


Updated: Christian Stevens, PhD and Hannah Thompson, MD MPH; July 12, 2024