The Dangers of Secondhand Smoke Are Serious, Especially In Multifamily Housing

Many people know that secondhand smoke is a health hazard.

However, most people, including many health professionals, don’t realize just how dangerous it is, especially inside multifamily housing like apartment buildings.

Why is Secondhand Smoke a Big Threat to Health?

According to the American Lung Association:

  • Secondhand smoke causes approximately 7,330 deaths from lung cancer and 33,950 deaths from heart disease each year.
  • Between 1964 and 2014, 2.5 million people died from exposure to secondhand smoke, according to the 2014 report from the U.S. Surgeon General. The report also concluded that secondhand smoke is a definitive cause of stroke.
  • Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide.
  • Secondhand smoke can cause heart attacks. Even relatively brief exposure can trigger a heart attack, according to a report by the Institute of Medicine.
  • Secondhand smoke is especially harmful to young children. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year. It also causes 430 sudden infant death syndrome (SIDS) deaths in the U.S. annually.
  • Secondhand smoke exposure may cause a buildup of fluid in the middle ear, resulting in 790,000 doctor’s office visits per year, as well as more than 202,000 asthma flare-ups among children each year.

Why Is Secondhand Smoke a Big Threat to the Risk of Cancer?

According to the American Cancer Society:

Secondhand smoke causes lung cancer, even in people who have never smoked.

In adults, it might be linked to cancers of the:

  • Larynx (voice box)
  • Nasopharynx (the part of the throat behind the nose)
  • Nasal sinuses
  • Breast

Exposure of mothers and babies to secondhand smoke is possibly linked to certain childhood cancers:

  • Lymphoma
  • Leukemia
  • Brain tumors

Dr. Claudia Miller, professor emeritus and leader of the Hoffman TILT (Toxicant-induced Loss of Tolerance) program at UT Health San Antonio, studies how smoke and other indoor air pollutants affect vulnerable people.

“When patients with these conditions—importantly, asthma, in children— seek healthcare, we doctors often fail to ask about secondhand smoke exposure, particularly for people living in multifamily buildings,” Miller said.

Why Is the Home a Worry When it Comes to Secondhand Smoke?

People spend more time at home than anywhere else.

This means that any family member potentially can develop health problems related to secondhand smoke, according to the American Cancer Society.

“Multi-unit housing where smoking is allowed is a special concern and a subject of research. Tobacco smoke can move through air ducts, wall and floor cracks, elevator shafts, and along crawl spaces to contaminate units on other floors, even those that are far from the smoke,” the agency wrote. “[Secondhand smoke] cannot be controlled with ventilation, air cleaning, or by separating smokers from non-smokers.”

This is why HUD adopted a smoke-free policy in public housing in 2018.

Smoke-free policies are the only way to prevent exposure to secondhand smoke in multifamily units, according to HUD, ChangeLab Solutions, and other health experts.

The American Society of Heating, Refrigerating, and Air Conditioning Engineers agrees.

“At present, the only means of effectively eliminating health risk associated with indoor exposure is to ban smoking activity,” according to their 2010 position statement that they reaffirmed in 2019.

Many cities are adopting smoke-free multifamily housing policies.

In California, dozens of cities have passed these ordinances. Berkeley, Calif., for example, prohibits smoking in all units and common areas of multi-unit housing.

What Can We Do to Promote Smoke-Free Housing and Reduce Exposure to Secondhand Smoke?

Check out UT Health San Antonio’s “Mil Gracias for Not Smoking Indoors!” campaign.

The Mil Gracias campaign is led by a group of local health experts: Dr. Amelie G. Ramirez, health disparities researcher and director of Salud America! and the Institute for Health Promotion Research at UT Health San Antonio; Dr. Claudia Miller, allergist/immunologist and professor emeritus at UT Health San Antonio; and Dr. Mandie Svatek, a pediatrician at UT Health San Antonio who leads the South Texas Asthma Coalition.

At the campaign website, you can take three big actions:

You can also access quit-smoking resources.

This includes Dr. Ramirez’s Quitxt program, developed with the support of the Cancer Prevention and Research Institute of Texas. Quitxt is a bilingual service for smartphones that sends messages via text or Facebook Messenger to help coach and encourage people on the journey toward smoking cessation.

“Smokers have the power to slow the spread of COVID-19 by taking it outside and away from people, protecting them from the known secondhand smoke dangers and the possibility of coronavirus airborne transmission,” Ramirez said. “Smokers who do not smoke indoors deserve our thanks.”

How chemically sensitive are you?

Answer these three questions from the Brief Environmental Exposure and Sensitivity Inventory (BREESI):

  • Do you feel sick when you are exposed to tobacco smoke, certain fragrances, nail polish/remover, engine exhaust, gasoline, air fresheners, pesticides, paint/thinner, fresh tar/asphalt, cleaning supplies, new carpet or furnishings? By sick, we mean: headache, difficulty thinking, difficulty breathing, weakness, dizziness, upset stomach, etc.
  • Are you unable to tolerate or do you have adverse or allergic reactions to any drugs or medications (such as antibiotics, anesthetics, pain relievers, X-ray contrast dye, vaccines or birth control pills), or to an implant, prosthesis, contraceptive chemical or device, or other medical/surgical/dental material or procedure?
  • Are you unable to tolerate or do you have adverse reactions to any foods such as dairy products, wheat, corn, eggs, caffeine, alcoholic beverages, or food additives (e.g., MSG, food dye)?

If you answer YES to any of these three questions, take the Quick Environmental Exposure and Sensitivity Inventory (QEESI) and share the results with your doctor!

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