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On the dangers of smoke: first, second and thirdhand

Tom Sinon

Most of us are aware of the harmful effects smoking can have on the body. From heart attacks to lung cancer, there’s no question that smoke inhalation has some nasty consequences.

To find out more about those consequences, Dr. Norman Edelman, senior scientific advisor of the American Lung Association, joined “Take Care” for a conversation on different smoking methods, as well as secondhand and thirdhand smoke.


Smoke, as Edelman explains, is a result of combustion. During this burning process, the combusted substance undergoes a physical change and releases smoke which contains very fine, particulate matter. Similar to air pollution, the particulate matter in smoke poses a risk to the health of those who inhale it.

Not only are those particles dangerous to breathe in, but the various substances found in smoking products are of concern, too. Cigarette smoke contains formaldehyde, commonly found to cause cancer. And in fact, formaldehyde is just one of the 4,000 different compounds found in cigarettes.

Burning these compounds, according to Edelman, does change them. When scientists evaluate the effects of smoking cigarettes, they not only look at what is in the cigarette but also what is in the smoke once it’s been burned.

“There’s a big difference between what’s in the cigarette and what comes out in the smoke,” Edelman says.

Other factors that can influence the effects of smoke include what exactly you’re smoking, how deeply you inhale, and how frequently you smoke. It would appear that irritation of the airways is the primary acute effect of smoking anything, whether it’s cigarettes, cigars, or marijuana cigarettes.

In terms of long term effects, epidemiologic studies show there is significantly more cancer among cigarette smokers than cigar smokers, although it is not unheard of for cigar smokers to get cancer. As far as marijuana smokers, you may see chronic bronchitis but, “we have not yet shown that marijuana smokers may get more lung cancer,” says Edelman. According to him, this may be because marijuana smokers are less likely to use regular cigarettes.

Credit ecig vap / Flickr

In order to lessen these harmful effects, many young people have turned to vaporizing (e-cigarettes) as an alternative to smoking. This is a big concern for the American Lung Association, because vaporizers still use nicotine, leaving opportunity for addiction to manifest. Vaporizing companies market primarily to teenagers, a demographic with plenty of time to develop a nicotine addiction. And what’s more, among teenagers who use e-cigs, Edelman notes that there is not a decrease in normal cigarette usage, but rather the same amount or more.

Secondhand smoke is another form of smoke exposure with harmful effects. Secondhand smoke includes the exhale of someone smoking, as well as any smoke coming from the burning substance.  The composition of the two are technically different, but according to Edelman, they are treated the same in epidemiology.

Past secondhand smoke, we also have thirdhand smoke. This qualifies as any lingering particulate matter clinging to material like hair or fabric. For example, when you can smell smoke on someone’s clothes, or in their car, that’s thirdhand smoke. There is increasing evidence of the dangers of thirdhand smoke and it is known irritate asthmatics, who can easily be triggered by any form of particulate matter.

In terms of long-term effects, secondhand smoke is not something to take lightly. It is proven to cause strokes, lung cancer, and heart attacks in adults. In children, it can cause infections of the ear and respiratory system. And in infants, it has even been associated with Sudden Infant Death Syndrome (SIDS).

So how do experts measure the impact of smoke? Is it the intensity or the duration? In general, according to Edelman, toxicity is categorized based on timing. Short term effects (coughing, for example) are measured by intensity. More whiffs of smoke means more coughing. Long term effects, on the other hand, take duration of exposure into consideration to understand how much time it takes to see those long-term health problems.

And as those health problems have been brought to light, more and more people are avoiding smoke altogether. In fact, since New York City has banned cigarette smoking in public places, the city saw a twenty percent decrease in heart attacks and stroke, says Edelman, making it a “very effective publish health measure.”

He also notes that wood smoke isn’t good for the lungs either, and this is something people should watch out for. Wood fireplaces, he says, should be avoided unless you need one to heat your home. If this is the case, there are fireplaces specially designed to minimize the smoke that escapes into your house. Like any type of smoke, wood smoke does contain particulate matter, making it harsh on the airways. And further, it contributes to air pollution in general.

On the subject of candles, Edelman acknowledges that they can be irritating, like any form of smoke, although he isn’t aware of any studies of the long term effects of candles.

If you’re concerned about your past exposure to smoke, Edelman does add that unfortunately, there is “nothing you can do to make the lungs recover from damage that’s been done.” But to protect yourself, you can try to avoid smoke in the future. Leading a healthy lifestyle, exercising, eating oxidant rich vegetables, and vaccinating yourself are all measures you can take to give your lungs some support. Also, if you have a history of secondhand smoke exposure, be sure to tell your physician when they ask about your personal smoking history.