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Clinical guidelines

Supporting smoking cessationA guide for health professionals

Secondhand smoke

Secondhand smoke, or passive smoking, can affect the health of people who do not smoke. There is clear evidence of the harms of exposure to environmental tobacco smoke in pregnancy, to children (higher rates of respiratory and middle ear infections, meningococcal infections and asthma) and adults (increased risk of lung cancer, coronary heart disease and stroke).217 The evidence for the health effects of secondhand smoking has been summarised by a number of health authorities including the National Health and Medical Research Council.12,92,149,218 The US Department of Health and Human Services has stated that there is no safe level of exposure to tobacco smoke. Any exposure to tobacco smoke – even an occasional cigarette or exposure to secondhand smoke – is harmful,24 especially to children.219

There is a lack of evidence on the effectiveness of counselling non-smokers to limit exposure to tobacco smoke. There is evidence that providing information to parents on the harms of exposing children to environmental tobacco smoke can reduce their exposure.109 Due to the evidence of harms from exposure, non-smokers, especially parents of babies and young children and pregnant women, should be strongly advised to limit exposure to tobacco smoke. Smoking parents should be encouraged not to smoke in the house or in a confined space such as a motor vehicle at any time.

Evidence

Introducing smoking restrictions into the home can assist quitting smoking successfully. Level IV

Recommendation

People attempting to quit should be advised to ban or restrict smoking by others in their homes. Strength C

References

  1. Partnership on Smoking Cessation. Guideline. Treatment of tobacco dependence. 2006. Available at http://www.treatobacco.net/en/uploads/documents/Treatment%20Guidelines/Netherlands%20treatment%20guidelines%20in%20English%202006.pdf [accessed 23 March 2011].
  2. US Department of Health and Human Services. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General. Atlanta GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.
  3. Benowitz NL. Neurobiology of nicotine addiction: implications for smoking cessation treatment. Am J Med 2008;121(4 Suppl 1):S3–10.
  4. Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence: clinical practice guideline. Rockville, MD: United States Department of Health and Human Services, 2000.
  5. Tzelepis F, Paul CL, Walsh RA, et al. Active telephone recruitment to quitline services: are nonvolunteer smokers receptive to cessation support? Nicotine Tob Res 2009;11:1205–15.
  6. The health consequences of smoking – 50 years of progress: a report of the Surgeon General. – Atlanta, GA. : U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
  7. National Health and Medical Research Council. The health effects of passive smoking. Canberra: NHMRC, 1997.
  8. Best D. From the American Academy of Pediatrics: Technical report. Secondhand and prenatal tobacco smoke exposure. Pediatrics 2009;124:e1017–44.
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