Faraz Siddiqui (24), a research analyst, was 23 when he smoked a cigarette for the first time only to discontinue it because of the discomfort it caused him. However, even though he left smoking, it didn’t leave him as his peers continued to smoke around him. Many times, people who do not smoke find themselves in the company of peers who do smoke or are chain smokers. These nonsmokers, who usually join their peers for an informal conversation, meeting, or work, end up being exposed to passive smoking.
Passive smoking or secondhand smoking is the smoke emitted from the burning end of a cigarette, bidi, or water pipe which is exhaled by a smoker and inhaled by a nonsmoker. According to Cancer Research UK, passive smoking means breathing in other people’s tobacco smoke. A smoker who is inhaling tobacco and exhaling its smoke causes direct harm to his own health and that of others too. If a person is smoking in the company of a nonsmoker, the health of the nonsmoker is just as adversely affected.
As per a 2016-17 Global Adult Tobacco Survey, nearly 30% adults in India are exposed to secondhand smoke. Exposure to secondhand smoke is known to cause serious health problems among adults and children alike. “While direct smoking is worse, passive smoking or being in a setup where others are smoking has similar negative effects", says Dr Vishal Rao, the director at the HCG Centre of Academics and Research. He further adds that while no level of exposure to second hand smoking is considered safe, not many people are aware of this silent killer.
Additionally, evidence suggests that secondhand smoking is associated with an increased risk of a variety of diseases and health problems, particularly those affecting children, making it just as dangerous as first-hand smoking. Vaishakhi Mallik, the associate director of policy advocacy and communication at Vital Strategies, shares, “Tobacco smoke contains more than 4,000 toxic chemicals and irrespective of whether one inhales that smoke or exhales it – it is hazardous to all.”
Health-Related Complications Induced by Passive Smoking
Syed Mustafa (24), an application development technician, got addicted to smoking cigarettes, which took a toll on his health. He shares, “I could notice the ill-effects on my health because of smoking. I would often feel dizzy and unconscious because of the nicotine high.”
Just like Mustafa, Asma Badr Khan (24), a master’s student at Jamia Millia Islamia, also complained of coughing, headaches, sore throat, nasal irritation, dizziness, and shortness of breath when people around her smoked.
According to the Global Adult Tobacco Survey 2016-17, the exposure of adults to secondhand smoke causes cardiovascular diseases, upper and lower respiratory tract infections, coronary heart disease, pulmonary diseases, and lung cancer amongst other comorbidities. Nonsmokers who are exposed to secondhand smoke at home or at work have a 25–30% increased risk of developing heart diseases and a 20-30% risk of getting a stroke. Nonsmokers, when exposed to secondhand smoke, may inhale many of the same cancer-causing substances and poisons that smokers do.
Passive smoking is so toxic and hazardous that even a brief exposure to smoke can damage the lining of blood vessels and cause blood platelets to become stickier. According to Dr Rao, these variations in platelets can further cause a heart attack as secondhand smoke has the potential to damage cells in ways that initiate the development of cancer cells in the body.
He adds, “Exposure to secondhand smoke raises the risk of lower respiratory tract infections in young children, asthma in both adults and children, and ischemic heart disease, and lung cancer in adults.”
Additionally, a 2015 report by Higgins et al on the prevalence of gender differences and intersections in tobacco use states that the ill effects of substance use and smoke are primarily borne by women, who are most often exposed to it by male smokers. Mallik also adds, “Women, children, and people who already have heart diseases are highly vulnerable to the negative effects of secondhand smoke.”
How Does Passive Smoking Affect Children?
Numerous studies have highlighted the relationship between secondhand smoking and sudden infant death syndrome (SIDS). Although not explained clinically, Dr Rao says that an abnormal respiratory control mechanism and factors such as maternal or paternal smoking in pregnancy can lead to SIDS. He further adds, “Even if the pregnant woman is not smoking but breathing in secondhand smoke or living in a household where others smoke, it can still affect the unborn baby."
Children of women who smoke during pregnancy are more susceptible to developing asthma as they grow. They have a 50% higher chance of developing at least two neuro-behavioural disorders, such as autism, ADHD, or the disruptive behaviour disorder.
According to Mallik, such children have suppressed immune systems as their parents smoke or have smoked in the past and as a result, they are more vulnerable to catching a cold, developing asthma, otitis media (ear infections), and respiratory complications such as tuberculosis, bronchitis, and pneumonia.
She further adds, “Secondhand smoke exposes children to poisonous chemicals, such as cyanide and carbon monoxide, that cause serious health problems.”
Long-term exposure to secondhand smoke also increases the risk of cardiovascular disease and affects children's pulmonary development.
Explaining the seriousness of the situation, Dr Rao highlights, “Because children don’t reach their maximum pulmonary capacity, they also are at a higher risk of testing positive for lung and upper respiratory tract cancers.”
Secondhand smoke also exposes children to obesity, overweight, low high-density lipoprotein-cholesterol, and high low-density lipoprotein-cholesterol.
Minimising the Effects of Secondhand Smoking
According to the Global Adult Tobacco Survey (GATS) 2017, there has been a reduction in exposure to secondhand smoke in India since 2009-2010, but a large proportion of adults and children are still exposed to this invisible killer.
A 2021 Lancet Global Health study found that even though exposure to secondhand smoke in public spaces decreased from 29% to 23% and exposure in homes decreased from 52% to 39%, exposure in workplaces rose from 29.9% to 30.2%.
Though Mustafa prefers that people don't smoke around him, when he can't avoid such situations, he protects himself by blowing the smoke away.
“I safeguard my health by avoiding the smoke either by blowing it away or holding my breath for a short duration to avoid inhaling the smoke. The key here is to not inhale the smoke at all."Syed Mustafa
Many others use hacks such as covering their face and mouth with handkerchiefs or avoiding being in smoke-ridden areas, however, this is not a permanent solution.
According to the World Health Organization, nearly 267 million adults (aged 15 years and above) in India (29% of all adults) are users of tobacco. It is imperative to reduce tobacco use in India and adopt lifesaving policies that reach hundreds of millions of people.
Along similar lines, Mallik states that it is important to protect people from the invisible killer of secondhand smoke by generating conversations, spreading awareness, and reinforcing laws.
She adds, “It is crucial to sensitise smokers on the serious diseases they may be spreading to the people around them including their loved ones, and also make nonsmokers aware of their right to health as outlined in smoke-free laws".
Talking on a personal level, propagating the message using media campaigns, and advertising is the key to motivate people to quit smoking. Timely enforcement of fully comprehensive smoke-free laws with no exemptions will be effective in protecting both smokers and nonsmokers. Along with the laws, the government must, on an urgent basis, continue spreading messages about secondhand smoke hazards in the interest of public health, Mallik concludes.
(Syed Ali Haider and Sanjana Chawla are Journalism students at AJK MCRC, Jamia Millia Islamia, and are working as independent journalists. Ali likes to report about finance, politics, international relations, history, and art & culture. Sanjana covers stories across gender, society, health, lifestyle, and entertainment.)
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