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Thirdhand Smoke is a Public Health Concern

Thirdhand smoke is now recognized as a health hazard. Thirdhand smoke is residual secondhand smoke that imbeds into upholstery, rugs, and onto walls, and other surfaces, lingering for weeks. New studies indicate that thirdhand smoke may be more dangerous than secondhand smoke, since thirdhand smoke does not dissipate quickly, and continuously emits respirable particles long after secondhand smoke takes place. Learn more from an April 1, 2010 ABC interview with Dr. Jonathan Winikoff, a pediatrician at Massachusetts General Hospital for Children in Boston.

Studies and Journal Articles

1. The May 31, 2011 issue of the journal Environmental Health Perspectives published a review of studies on thirdhand smoke, Thirdhand Tobacco Smoke: Emerging Evidence and Arguments for a Multidisciplinary Research Agenda. Highlights of the review:
• The persistence of thirdhand smoke in real-world residential settings has been demonstrated based on nicotine and 3-EP concentrations in air, dust, and surfaces in the days, weeks, and months after the last smoking has taken place. Further support comes from quantitative measurements of ultrafine tobacco smoke particles resuspended after their deposition on household surfaces.
• Thirdhand smoke is ubiquitous and pervasive wherever tobacco has been smoked. Its presence in air and dust and on surfaces allows for multiple exposure routes, and thirdhand smoke creates special risks for nonsmokers who spend time indoors in proximity to polluted surfaces. Infants and children are especially vulnerable, because of their increased exposure and increased sensitivity to pollutants, as are persons with limited mobility and populations that spend time in multiunit housing and spaces with frequent changes in occupancy.
• The presence of thirdhand smoke compounds in the air, in dust, and on surfaces of indoor environments creates potential exposure routes through inhalation, ingestion, and dermal transfer. It is estimated that infants and young children are 100 times more sensitive than adults to pollutants in house dust because of such factors as increased respiration relative to body size and immature metabolic capacity. These pathways are likely to be relevant for children living in homes in which adults smoke, even if smoking occurs at times or in rooms when no children are present.
• The review stated that tobacco smoke contains volatile organic compounds (VOCs), and the constituents of thirdhand smoke identified to date include nicotine, 3-ethenylpyridine (3-EP), phenol, cresols, naphthalene, formaldehyde, and tobacco-specific nitrosamines.
• Knowledge about THS could be used clinically to encourage home and car smoking bans among individuals and to promote cessation.
2. The October 30, 2010 issue of Tobacco Control Journal published the San Diego State University study, "When smokers move out and non-smokers move in:residential thirdhand smoke pollution and exposure". The researchers concluded:

   "THS in a home lingers for more than 2 months, after the smokers move out." THS accumulates in smokers' homes and persists when smokers move out even after homes remain vacant for 2 months and are cleaned and prepared for new residents. When non-smokers move into homes formerly occupied by smokers, they encounter indoor environments with THS polluted surfaces and dust. Results suggest that non-smokers living in former smoker homes are exposed to THS in dust and on surfaces. Researchers visited homes of 100 smokers and 50 non-smokers, both before and after the residents moved out. Nicotine measurements were take on residents' fingers, in dust and the air, and on surfaces, and cotinine levels were measured from children's urine samples. New nonsmoking residents who moved into these homes were recruited and similarly tested, along with the dust, air and surfaces. "Finger nicotine levels among non-smokers living in former smoker homes were significantly correlated with dust and surface nicotine and urine cotinine."

   Read this Tobacco Control Journal editorial "Thirdhand smoke: here to stay" by Suzaynn Schick, discussing the above study and the health concerns with thirdhand smoke.
3. Time magazine's November 8, 2010 story (pg. 66), New Smoke Alarm reports that "current evidence surrounding thirdhand smoke should be enough to convince parents that no level of cigarette smoke exposure is safe for their children, not to mention themselves." Time writer Alice Park concludes: "Of the 22 million children in the U.S. who are exposed to smoke in the home: it's not enough to have smokers stand outside on the porch-unless they're planning to take a shower and change their clothes before they rejoin the party in the living room."
4. Researchers have found that clinging residue from tobacco smoke may linger and mix with common pollutants to form carcinogens and tiny particles that are potentially hazardous to children. Read about the September, 2010 University of California studies on the harmful effects of thirdhand smoke exposure.
5. The scientists at the Institute for Hygiene and Biotechnology (IHB) at the Hohenstein Institute studied whether and to what extent "third-hand smoke", in the form of the toxic substances on clothing, could damage the health of infants by examining whether there are other health risks to infants if the transmission channel is the skin. Mainly, they wanted to find out exactly what happens when parents have a smoke outside on the balcony and then, after their break, take their baby in their arms again. Click here to read the article from September 22, 2010 entitled When Baby Smokes Too.
   

   "Parents should be aware", says Prof. Dirk Hofer, Director of the Institute for Hygiene and Biotechnology at the Hohenstein Institute, "that their own clothing can transmit toxins from cigarette smoke."

6. A new potential health hazard from thirdhand smoke was revealed in a 2010 study by the U.S. Department of Energy. The study concluded that nicotine in thirdhand smoke (which is tobacco smoke residue that imbeds into surfaces, e.g. furniture, carpet, clothing, skin, etc.), when it reacts with nitrous acid, a common indoor air pollutant, forms dangerous carcinogenic tobacco-specific nitrosamines (TSNAs), such as NNN and NNK. Key findings as noted in the study's February 8, 2010 press release:

   "TSNAs are among the most broadly acting and potent carcinogens present in unburned tobacco and tobacco smoke."
   "We know that these residual levels of nicotine may build up over time after several smoking cycles, and we know that through the process of aging, third-hand smoke can become more toxic over time..."
   "... [T]he results of this study should raise concerns about the purported safety of electronic cigarettes.... A battery-powered vaporizer inside the tube of a plastic cigarette turns a solution of nicotine into a smoky mist that can be inhaled and exhaled like tobacco smoke.... What we see in this study is that the reactions of residual nicotine with nitrous acid at surface interfaces are a potential cancer hazard, and these results may be just the tip of the iceberg."
   "Co-authors suggest various ways to limit the impact of the thirdhand smoke health hazard, starting with the implementation of 100 percent smoke-free environments in public places and self-restrictions in residences and automobiles. In buildings where substantial smoking has occurred, replacing nicotine-laden furnishings, carpets and wallboard might significantly reduce exposures."

   The Proceedings of the National Academy of Sciences (PNAS) published a paper on this study, entitled "Formation of carcinogens indoors by surface-mediated reactions of nicotine with nitrous acid, leading to potential third-hand smoke hazards." It is the first study to quantify the reactions of third-hand smoke with nitrous acid. The Lawrence Berkeley National Laboratory is a U.S. Department of Energy (DOE) national laboratory that conducts unclassified scientific research for DOE's Office of Science and is managed by the University of California. Listen to an NPR/Sound Medicine clip by Jeremy Shere interviewing Lara Gundel, one of the scientists researching thirdhand smoke at the Berkeley Labs. Read the study and see the study's supporting information.

7. Click here for a NY Times article with information from the January, 2009 Pediatrics study, which discusses the hazards of exposure to third-hand smoke, present on the walls, in carpeting, furniture, etc., that lingers beyond the extinguishing of a cigarette or cigar. Read the study abstract.
   Key findings:
   • Carcinogens and toxins in third-hand smoke may affect brain development in babies and young children.
   • Young children crawl on carpeting and suck on clothing, upholstery, skin, etc. that has third-hand smoke residue.
   • Increasing awareness of how third-hand smoke harms the health of children may encourage home smoking bans.
   • Professor Winickoff is also concerned about new mothers who smoke, saying: 'When you're near your baby, even if you are not smoking, the child comes into contact with those toxins. And if you breastfeed, the toxins will transfer to your baby in the breast milk.' See press release at http://www.massgeneral.org/about/pressrelease.aspx?id=1091.
   Click here for the October 2008 American Journal of Public Health article, on ethical support for mandating smoke-free private spaces, such as cars and homes, in which children will be exposed.
8. Click here for information on the 2004 San Diego State University study published in Tobacco Control, on thirdhand smoke exposure inside the home. The study found that parents who smoke outside the home still subject their children to passive smoking. Children in such homes have up to eight times more nicotine in their bodies than the offspring of non-smokers. Moreover, nicotine levels in babies who live in houses where people smoke outside are much higher than in babies who live with non-smokers:
• Infants may inhale the smoke from a cigarette or the exhaled air from a smoker.
• Even if cigarettes are not smoked near a baby, cigarette fumes may contaminate dust that settles in carpets, on toy and furniture surfaces and on the floor.
• Because babies spend a lot of time crawling on the floor and put toys in the mouths, they are especially at risk to ingest this contaminated dust.
• Smokers may also contaminate their homes by bringing in clothing exposed to smoke.
• Matt, G.E., Quintana, P.J.E., Hovell, M.F., Bernert, J.T., Song, S., Novianti, N., Juarez, T., Flora, J., Gehrman, C., Garcia, M. and Larson, S. Households contaminated by environmental tobacco smoke: sources of infant exposures. Tobacco Control, 13:29-37, 2004. Cited from http://faculty.washington.edu/chudler/shs.html.
• Although all smoking was outdoors, children had nicotine in their hair and urine, and mothers who smoked away from their children were found to have nearly as much nicotine on their hands as smokers who made no special effort. Cited from http://www.thestressoflife.com/smoking_outside_may_not_protect_.htm.

Lawsuit Award in Favor of Nonsmoking Homeowner

In 2007, the County Court of Lancaster County, Nebraska ruled in favor of a home buyer, in finding that the seller fraudulently misrepresented that they had not smoked in the home. The court awarded the home buyer more than $12,000 in costs related to attempting to mitigate the thirdhand smoke residue, during the time that the buyer had moved in. The seller represented that they did not currently smoke in the home, which was in untrue. The buyer only lived at the premises for less than 1 month. (Contact GASP for detailed information on this lawsuit).

GASP Presentations

Concerns with thirdhand smoke exposure in the home are discussed in GASP's presentation entitled, Hot Topics In Tobacco Control, presented at NJ Environmental Health Association Educational Conference and Exhibition, Atlantic City, NJ, March 8, 2010.

Learn more about secondhand smoke exposure in the home, as discussed in presentations found in the GASP Library.

Last update: 2/11/11

This information is created by the Tobacco Control Policy and Legal Resource Center of New Jersey GASP, which provides expert information, guidance, and technical assistance about policy, legislation, and litigation, especially regarding smokefree air. The information presented by GASP is not intended as, nor to be construed, or used, as legal advice, and should not be used to replace the advice of your legal counsel.