4.11 Effects of secondhand smoke on the respiratory system in adults

Last updated: January 2017
Suggested citation: Campbell MA, Ford C, & Winstanley MH. Ch 4. The health effects of secondhand smoke. 4.11 Effects of secondhand smoke on the respiratory system in adults. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2017. Available from http://www.tobaccoinaustralia.org.au/chapter-4-secondhand/4-11-effects-of-secondhand-smoke-on-the-respiratory

Secondhand smoke affects the respiratory system of non-smokers through mechanisms similar to the effects seen in active smoking. However, since the levels of exposure to secondhand smoke are lower than in active smoking, the effects of secondhand smoke tend to be less severe.1

Non-smokers exposed to secondhand smoke commonly experience eye, nasal and throat irritation.1 This group also have elevated nasal ciliary beat frequency (a defence mechanism that transports secretions, particles and other substances out of the nasal passages) comparable to smokers.2 One hour’s exposure to high levels of secondhand smoke, such as that found in bars or restaurants with unrestricted smoking, can produce an acute decline in lung function and airflow restriction.3 Among non-smokers, secondhand smoke exposure has been associated with a range of chronic and acute respiratory symptoms, such as cough, phlegm and sputum production, wheezing and shortness of breath.1

Secondhand smoke may be responsible for causing the onset of asthma in adulthood, increasing symptoms and making the management of asthma more difficult.1 People with asthma have a small acute decline in lung function following exposure to secondhand smoke.1 Chronic exposure to secondhand smoke is associated with a small decrement in lung function in the general adult population, but more research is needed to determine if this effect actually reflects a larger decrement in susceptible sub-groups (such as those with asthma).1

Adults exposed to secondhand smoke have a higher likelihood of snoring,4 and are at greater risk of experiencing respiratory complications during surgery involving anaesthesia.5 Secondhand smoke exposure has been associated with rhinosinusitis,6 and worsens the symptoms of blocked nose, nasal discharge, headaches and cough.7, 8 Secondhand smoke may also exacerbate symptoms or progression of disease among adults with poor lung function,9 or lung disease such as those with asthma and cystic fibrosis.10

Research suggests that exposure to secondhand smoke may cause an elevated risk of developing chronic obstructive pulmonary disease (COPD), which is marked by permanent and progressive damage to the airways and airway sacs of the lung.1, 11 COPD results in reduced lung function that is largely irreversible.1 There is some evidence to suggest that exposure to maternal smoking and secondhand smoke as a child may lead to impaired lung growth and development that persists into adulthood, contributing to the development of COPD.1 Among those with diagnosed COPD, exposure to secondhand smoke may contribute to increased airway wall thickness and poorer health outcomes.12

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1. US Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2006/index.htm

2. Zhou H, Wang X, Brighton L, Hazucha M, Jaspers I, et al. Increased nasal epithelial ciliary beat frequency associated with lifestyle tobacco smoke exposure. Inhalation Toxicology, 2009; 21(10):875–81. Available from: http://www.informahealthcare.com/doi/full/10.1080/08958370802555898?cookieSet=1

3. Flouris A, Vardavas C, Metsios G, Tsatsakis A, and Koutedakis Y. Biological evidence for the acute health effects of secondhand smoke exposure. American Journal of Physiology. Lung Cellular and Molecular Physiology, 2009; 298(1):L3–12. Available from: http://ajplung.physiology.org/cgi/reprint/00215.2009v1.pdf

4. Franklin K, Gíslason T, Omenaas E, Jõgi R, Jensen E, et al. The influence of active and passive smoking on habitual snoring. American Journal of Critical Care Medicine, 2004; 170:799–803. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15242843

5. Moller A and Tonnesen H. Risk reduction: Perioperative smoking intervention. Best Practice Research and Clinical Anaesthesiology, 2006; 20:237–48. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16850775

6. Shargorodsky J. Secondhand smoke and rhinitis. Current Opinions in Otolaryngology and Head and Neck Surgery, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27054622

7. Reh D, Lin S, Clipp S, Irani L, Alberg A, et al. Secondhand tobacco smoke exposure and chronic rhinosinusitis: A population-based case-control study. American Journal of Rhinology & Allergy, 2009; 23(6):562–7. Available from: http://www.ingentaconnect.com/content/ocean/ajra/2009/00000023/00000006/art00016;jsessionid=2fp3n7eyhmic7.victoria

8. Tammemagi C, Davis R, MS B, Holm A, and Krajenta R. Secondhand smoke as a potential cause of chronic rhinosinusitis: A case-control study. Archives of Otolaryngology Head & Neck Surgery, 2010; 136(4):327–34. Available from: http://archotol.ama-assn.org/cgi/content/full/136/4/327

9. National Health and Medical Research Council. The health effects of passive smoking: A scientific information paper. Canberra: Australian Government Publishing Service, 1997

10. Office of Environmental Health Hazard Assessment and California Air Resources Board. Health effects of exposure to environmental tobacco smoke: Final report, approved at the Panel's June 24, 2005 meeting. Sacramento: California Environmental Protection Agency, 2005. Available from: http://www.oehha.ca.gov/air/environmental_tobacco/2005etsfinal.html

11. Perret JL, Walters H, Johns D, Gurrin L, Burgess J, et al. Mother's smoking and complex lung function of offspring in middle age: A cohort study from childhood. Respirology, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26969872

12. Putcha N, Barr RG, Han MK, Woodruff PG, Bleecker ER, et al. Understanding the impact of second-hand smoke exposure on clinical outcomes in participants with COPD in the spiromics cohort. Thorax, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26962015