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Adults and children exposed to second-hand smoke inhale many of the same carcinogens as smokers do. Second-hand smoke can cause lung cancer in people who have never smoked, and it may also be linked to other cancers in adults (e.g. breast cancer) and children. Second-hand smoking may increase the overall risk for all cancers by up to 16% in never smokers (Kim et al., 2018). Around 31% of the European population on average is exposed to second-hand tobacco smoke at home, at work, during leisure activities, in educational institutions or in public settings (Henderson et al., 2020). That exposure can be significantly reduced by implementing total smoking bans in public places, as shown by Nogueira et al. (2022).
It is difficult to assess exposure to second-hand smoke across a multitude of settings and age groups, and there seems to be considerable heterogeneity across European countries. A study by Ma et al. (2021) found a mixed picture in Europe in adolescents aged 12-16: from 1999 to 2018 their exposure increased, decreased or remained unchanged depending on the country. Another study covering 12 EU countries found very different levels of second-hand smoke outdoors (including around hospitals and schools): the presence of second-hand smoke was higher in countries with a higher prevalence of smoking and with less comprehensive tobacco control policies (Henderson et al., 2021).
In parallel to adopting a body of regulations and action on tobacco control, advertising, promotion and sponsorship (DG SANTE, 2021), the EU has issued a Council recommendation on smoke-free environments and is supporting Member State’s efforts in implementing the WHO Framework Convention on Tobacco Control. In addition, several EU Member States have banned smoking in public places, mainly indoors but in some cases also in outdoor areas (Henderson et al., 2021). To support the reduction of secondhand smoking, Europe’s Beating Cancer Plan will help creating a ‘Tobacco-Free Generation’ where less than 5% of the population uses tobacco by 2040, compared to around 25% today. The European Code against Cancer addresses exposure to second-hand smoke at work and at home by calling upon citizens to ‘Make your home smoke free. Support smoke-free policies in your workplace’.
DG SANTE, 2021,Study appendices to final report: Study on smoke-free environments and advertising of tobacco and related products, European Commission Directorate-General for Health and Food Safety (https://op.europa.eu/en/publication-detail/-/publication/19bcb4c3-5d5a-11ec-9c6c-01aa75ed71a1/language-en).
Henderson, E., et al., 2020, ‘Secondhand smoke exposure and other signs of tobacco consumption at outdoor entrances of primary schools in 11 European countries’,Science of the Total Environment743, p. 140743 (DOI: 10.1016/j.scitotenv.2020.140743).
Henderson, E., et al., 2021, ‘Secondhand smoke presence in outdoor areas in 12 European countries’,Environmental Research195, p. 110806 (DOI: 10.1016/j.envres.2021.110806).
Kim, A.-S., et al., 2018, ‘Exposure to secondhand smoke and risk of cancer in never smokers: a meta-analysis of epidemiologic studies’,International Journal of Environmental Research and Public Health15(9), p. 1981 (DOI: 10.3390/ijerph15091981).
Ma, C., et al., 2021, ‘Global trends in the prevalence of secondhand smoke exposure among adolescents aged 12-16 years from 1999 to 2018: an analysis of repeated cross-sectional surveys’,The Lancet Global Health9(12), pp. e1667-e1678 (DOI: 10.1016/S2214-109X(21)00365-X).
Nogueira, S. O., et al., 2022, ‘Secondhand smoke exposure in European countries with different smoke-free legislation: findings from the EUREST-PLUS ITC Europe surveys’,Nicotine & Tobacco Research24(1), pp. 85-92 (DOI: 10.1093/ntr/ntab157).
Cover photo © Pascal Meier on unsplash.com
For references, please go to https://www.eea.europa.eu/publications/environmental-burden-of-cancer/second-hand-smoke or scan the QR code.
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