Secondhand Smoke and Smokefree Environments

Secondhand Smoke

There is no safe level of secondhand smoke exposure.[1] Exposure to secondhand smoke, even for a short time, can cause health problems in children and adults, and can even be deadly.[2] In the U.S., it contributes to approximately 41,000 deaths among nonsmoking adults and 400 deaths in infants each year.[3] Since 1964, about 2.5 million nonsmoking people have died from health problems caused by secondhand smoke exposure.[4]

Secondhand smoke causes stroke, lung cancer, and heart disease in adults.[5] Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth.[6]

Secondhand Aerosol

E-cigarette aerosol is not water vapor, and it is also not harmless.

E-cigarette aerosol can contain:[7][8]

  • Nicotine.
  • Cancer-causing chemicals.
  • Heavy metals like nickel, tin, and lead.
  • Ultrafine particles that can be inhaled deep into the lungs.
  • Flavoring such as diacetyl, a chemical linked to a serious lung disease known as "popcorn lung".

Secondhand aerosol exposes bystanders to harmful substances.

Smokefree Environments

Smokefree environments are any places where people are protected from exposure to secondhand smoke and other forms of tobacco product use.

Smokefree environments can include, but are not limited to:

  • Municipalities.
  • Multiunit housing.
  • Worksites.
  • Public spaces.

The only way to fully protect nonsmoking people from secondhand smoke is through implementation of smokefree environments.[9]

Smokefree environments contribute significantly to public health by:[10]

  • Improving air quality.
  • Reducing secondhand smoke exposure.
  • Improving peoples' health.
  • Reducing smoking in youth, young adults, and adults.
  • Reducing and preventing health disparities related to secondhand smoke exposure, illness, lost productivity, and death.

Smokefree Municipalities

The list continues to grow of Texas municipalities that have adopted a comprehensive smokefree municipal ordinance to protect people from exposure to secondhand smoke.

The Texas Tobacco Prevention and Control Program contracts with the University of Houston to maintain an online and publicly accessible database for municipal ordinances. Of the 1,220 municipalities in Texas, 99 have 100% smokefree ordinances as evaluated by the University of Houston.

Visit the Texas Smokefree Ordinance Database.

Smokefree Housing

The home is the main place many infants, children, and adults breathe in secondhand smoke. According to the 2021 Texas Youth Tobacco Survey, 21% of 6th-12th grade students indicated that they were in the same room as someone who smokes.

Secondhand Smoke in the Home:

  • Secondhand smoke can travel through doorways, cracks in walls, electrical lines, ventilation systems, and plumbing.
  • Cleaning the air and ventilating homes or multiunit buildings cannot get rid of secondhand smoke.
  • Air conditioning and ventilation systems can distribute secondhand smoke throughout a home or multiunit building.

For multiunit housing, going smokefree would save $153 million each year, including $43 million in cleaning costs and $16 million from preventable fires.

According to the U.S. Department of Housing and Urban Development, all public housing authorities are required to have a smoke-free policy for buildings and property by July 31, 2018. Visit the Texas Smokefree Public Housing Database.

Tobacco Free Schools

Per Section 38.006, Texas Education Code, Texas public schools are tobacco-free environments. Smoking or using tobacco is prohibited at a school-related or school-sanctioned activity on or off school property.

Download a Tobacco Free School Toolkit.

Smokefree Worksites

A smokefree worksite is an environment in which tobacco product use of any kind, including smokeless tobacco and e-cigarettes, is prohibited. A smokefree worksite can enhance productivity by reducing tobacco-related absenteeism, improving air quality, and decreasing insurance costs among employees who stop using tobacco products.

To learn more about how employers can create a smokefree worksite, download the Tobacco-Free Workplace toolkit.

DSHS Contractor Tobacco Free Worksite Policy

All contractors with DSHS must certify that they have adopted and enforce a tobacco free worksite policy that meets or exceeds DSHS minimum standards.

Download a sample policy.

Download an exemption form.


[1] Centers for Disease Control and Prevention. (2022). General Information About Secondhand Smoke.

[2] Centers for Disease Control and Prevention. (2022). Secondhand Smoke.

[3] Ibid.

[4] Ibid.

[5] Ibid.

[6] Ibid.

[7] U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.

[8] Centers for Disease Control and Prevention. (2022). Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults.

[9] Centers for Disease Control and Prevention. (2022). Secondhand Smoke.

[10] Centers for Disease Control and Prevention. (2022). Going Smokefree Matters: Multiunit Housing.