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About Secondhand Smoke

Why measure SHS?

The scientific evidence on the adverse health effects of SHS exposure has led to the development of policies to protect the health of non-smokers. The World Health Organization’s Framework Convention on Tobacco Control (FCTC) calls for legislation to protect non-smokers from exposure to tobacco smoke, and requires that all ratifying countries implement smoke-free policies in public places.The only effective way to protect individuals from the harms of SHS is to establish 100 percent smoke-free environments. Ventilation and separate smoking areas do not adequately protect non-smokers from SHS.2,3

Evaluating SHS exposure continues to be an important issue as waterpipe smoking, also known as hookah, becomes more prevalent worldwide. Because most tobacco control regulations remain limited to cigarettes, it is important to generate evidence on the secondhand smoke exposure produced by waterpipes in order to develop more effective tobacco control policies.4

Generation of local data through effective environmental and exposure monitoring is essential to reduce SHS. SHS monitoring can be used to:

  • motivate smoke-free policy development
  • estimate health risks to workers and the public
  • check compliance with existing regulations and laws
  • identify areas needing more effective control
  • evaluate the impact of policies and interventions

1 World Health Organization, 2003.
2 World Health Organization, 2007.
3 U.S. Dept. of Health and Human Services, 2006.
4 Torrey CM, Moon KA, D'Ann LW, Green T, Cohen JE, Navas-Acien A, Breysse PN. Waterpipe cafes in Baltimore, Maryland: Carbon monoxide, particulate matter, and nicotine exposure. Journal of Exposure Science and Environmental Epidemiology. 2014 April 16; [Epub ahead of print]; doi: 10.1038/jes.2014.19.


This project is funded by the Bloomberg Initiative to Reduce Tobacco Use and the Flight Attendant Medical Research Institute (FAMRI), developed in consultation with Roswell Park Cancer Institute and the University of Southern California, Institute for Global Health.