The dangers of second-hand smoke: what the research shows


One of the proposals in the Draft Tobacco Control Bill is to introduce 100% smoke-free public places. The National Council Against Smoking supports this proposal because there is evidence that this will protect the health of non-smokers and also encourages smokers to stop smoking.

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. Second-hand smoke cannot be controlled with ventilation, air cleaning, or by separating smokers from non-smokers.

The logic is that exposure to second-hand smoke as well as the pollution from tobacco smoke are key risk factors for non-communicable diseases. In adults, second-hand smoke causes lung cancer, stroke and heart disease (including heart attacks). Second-hand smoke increases the risk of stroke by between 20% and 30% and increases the risk of coronary heart disease by between 25% and 30%.

In South Africa, there is a heavy exposure to second-hand smoke. Research that looked at how high school children in the country were exposed to second-hand smoke found that 25.7% of young people were exposed to second-hand smoke at home. And among adults, the research shows that more than 30% of non-smoking adults were exposed to second-hand smoke in restaurants and more than 30% in bars.

A recent study of restaurant industry by the Economics of Tobacco Control Project at the University of Cape Town found that 45% of restaurants are completely smoke-free with 57% of franchisers not allowing smoking in their restaurant at all. More than 40% of restaurants have smoking areas outside and just 11% of restaurants have smoking areas inside. There was little evidence of customer disapproval to these changes.

The study shows that the majority of restaurants (59%) reported no change in revenue after the partial smoking ban was introduced in 2001, with a small proportion (22%) reporting an increase in revenue and a slightly smaller proportion (19%) reporting a decrease in revenue (Van Graan et al., 2007).

The Draft Bill also provides for protection to workers in private homes. The current Tobacco Control Act does not cover domestic workers in private homes. This therefore inadvertently allowed for them to be exposed to second-hand smoke while at work.

The proposals also prohibits smoking in a car when a child under the age of 18 is present. This will protect children from the harmful effects of second-hand smoke.

In the recent Drakenstein Child Health Study, conducted by UCT’s paediatrics Department one in five babies surveyed in two townships had the same level of nicotine in their system as active smokers. Many infants face the consequences of high smoking rates among pregnant women, including being underweight and developing lung problems such as asthma.

In children, second-hand smoke causes sudden infant death syndrome (SIDS), low birth weight, impaired lung function, respiratory infections (such as bronchitis and pneumonia), chronic and acute respiratory symptoms (such as coughing and breathlessness), ear infections and exacerbated asthma attacks that occur more often. The evidence suggests that second-hand smoke is a risk factor for children to develop asthma.

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