Thirdhand Smoke

Download the Thirdhand Smoke – What You Need to Know PDF.


What is thirdhand smoke?

Thirdhand smoke is the residue of tobacco smoke that accumulates on surfaces, textiles, and people after smoking has occurred in a room. While the harms of secondhand smoke exposure are reduced once the smoke clears, thirdhand smoke lingers long after the secondhand smoke has dissipated – even years. Because thirdhand smoke does not simply go away once combustion has ended, nonsmokers’ exposure to hazardous particles can occur long into the future.

Is thirdhand smoke harmful to your health?

Health officials warn that exposure to thirdhand smoke may contribute to smoking-attributable disease and death. When residual nicotine reacts to certain chemicals in the air it forms cancer-causing agents that continue to develop over time. The level of carcinogens found in thirdhand smoke has been found to be higher than the levels recommended by the EPA for exposure by children age 1-6. Also, when nicotine reacts with ozone in the air it forms “ultrafine” particles, which can transport harmful chemicals. A recent study has even found that exposure to thirdhand smoke can cause genetic damage to human cells.

Where can thirdhand smoke be found?

Thirdhand smoke is found in areas where smoking once occurred. It can accumulate on walls, floors, rugs, carpets, curtains, counters, appliances, pillows, blankets and beds; car upholstery; hotel rooms; and on skin, hair, and clothing. Residual nicotine has been found in ceiling tiles even 30 years after the last smoking occurred.

Who is most at risk for thirdhand smoke exposure?

Small children are at the highest risk for thirdhand smoke exposure. Infants and toddlers spend a lot of time on the floor and can ingest up to 0.25g of dust per day. When children sleep or play on surfaces with thirdhand smoke, they absorb the contaminants through their skin or breathe it in through the dust. Children living in smoking homes may also be exposed to thirdhand smoke via family members’ clothing and skin. Increased respiratory symptoms have been measured in children exposed to thirdhand smoke at home.

What should be done to prevent exposure?

Make your home 100 percent smoke-free. Simply cleaning does not completely remove thirdhand smoke contaminants from a room. Tests have found measurable levels of nicotine in new residents of formerly-smoking homes and hotel rooms – even after the unit has been professionally cleaned and left unoccupied for months! In such properties, it may be necessary to replace carpeting, wall boards, counters, and furnishings to completely eliminate exposure to tobacco-specific toxins carcinogens. Additionally, new owners or renters of formerly-smoking homes should be given notice of the home’s former smoking status.

This paper was made possible by a grant from the Centers for Disease Control and Prevention (CDC) (Grant Number: 1H75DP004181-01) to the Chicago Public Schools (CPS) Office of Student Health and Wellness, Healthy CPS. The views expressed in this publication do not necessarily reflect the views, opinions and official policies of CDC.

Issue Brief – ACA is Good for Lung Health

Download the Issue Brief – Affordable Care Act is Good for Lung Health PDF.


Executive Summary

In March 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law. Since that time, more than one million Illinois residents gained insurance coverage through either the Health Insurance Marketplace or the Medicaid Expansion, and the uninsured rate in Illinois has fallen by 49 percent.

With ongoing threats to the ACA from Congress, advocates are taking a close look at how its possible repeal will impact vulnerable populations, both locally and nationally, with a particular focus on the numbers who will lose their health care coverage.

With this brief, the Respiratory Health Association (RHA) focused on why a repeal of the ACA would be bad for lung health. Several provisions of the ACA have been particularly valuable to efforts to prevent and improve health outcomes for people living with asthma and other respiratory conditions; we highlight four of those:

  • Dependent Coverage for Young Adults: Reducing Asthma Emergency Room Visits
  • Medicaid Expansion: Improving Quality of Asthma Care
  • The Prevention and Public Health Fund: Supporting Tobacco Control
  • Requiring Coverage for Pre-Existing Condition: Making Treatment Affordable

Date of Publication: May 2017


If you have questions or would like additional information about the Affordable Care Act and lung health, please contact Erica Salem via email or by phone (312) 628-0235.

Smoke-free Parks

Download the White Paper: Smoke-free Parks PDF.


A comprehensive review of the policy considerations underlying state and municipal smoke-free parks laws.

Executive Summary

Smoke-free parks policies have increased in popularity over the last decade. As of January, 2014, more than 900 municipalities in the U.S have enacted smoke-free parks policies. Several dozen additional municipalities are currently weighing policy options regarding smoke-free parks.

Notwithstanding the current trend, some demographic disparities exist among communities adopting smoke-free parks policies. As public health organizations work to address the disproportionate impact of tobacco use on economically underdeveloped communities and other vulnerable populations, such as youth, it will be more important than ever to enact health policies supported by data.

The paper examines the justifications for smoke-free park policies, specifically:

  1. The individual health impact of exposure to outdoor tobacco smoke;
  2. The environmental impact of tobacco litter; and
  3. The public health impact of reinforcing smoke-free environments as a social norm.

The paper also identifies some of the arguments used most frequently in opposition to such ordinances.

Finally, this paper presents some of the leading policy considerations for communities contemplating the adoption of smoke-free parks.


Todd D. Fraley, JD
Kate Sheridan, MPH
Joel J. Africk, JD
Matt Maloney


This paper was made possible by a grant from the Centers for Disease Control and Prevention (CDC) (Grant Number: 1H75DP004181-01) to the Chicago Public Schools (CPS) Office of Student Health and Wellness, Healthy CPS. The views expressed in this publication do not necessarily reflect the views, opinions and official policies of CDC.

This paper has been written with a general audience in mind and is provided for educational purposes only and is not to be construed as legal opinion. Policy makers considering regulating smoking in outdoor environments within their municipalities should consult with their city law departments or other legal counsel.

Date of Publication: March 2014