56 Million Americans Don’t Know They’re Exposed to Tobacco Smoke – Thirdhand Smoke Could be to Blame

Over half of Americans who don’t smoke are exposed to tobacco, but only one-third are aware of it, according to a recent University of Florida study.

The Florida researchers reviewed data from the 2013-2020 National Health and Nutrition Examination Surveys. They found that 51% of nonsmoking people had cotinine in their blood, which signals nicotine exposure. Of this group, only one-third thought they had been exposed – the other two-thirds did not.

These data suggest that 56 million Americans are exposed to tobacco smoke and don’t know it.

Silhouette rows of people standing with the words "56 Million Americans" in frontOne reason for this large knowledge gap could be that Americans aren’t aware of thirdhand smoke, the chemical residue from tobacco smoke that sticks on and embeds in surfaces. Thirdhand smoke can be hidden and odorless. People can ingest it, absorb it through their skin, and inhale it when it is released into the air off of surfaces. People exposed to it can transport it on their skin, hair, and clothes to smokefree places. Furniture and household objects can carry it, too.

People might assume they are safe from tobacco smoke exposure if they aren’t around anyone smoking, i.e., secondhand smoke. Since thirdhand smoke is sticky and can be transported, however, people could be exposed to tobacco smoke chemicals in places where anyone smoked in the past or people visited after smoking.

Additional research suggests that compared to the number of Americans who consider secondhand smoke dangerous, fewer Americans don’t consider thirdhand smoke bad for their health. Some don’t know about it at all.

This may explain why millions of Americans are unaware of their exposure. Tobacco exposure and its resulting health symptoms disproportionally affect low-income families. Weak property disclosure laws do not include smoking history and make it difficult for families to buy or rent smokefree homes. Smoking bans often have loopholes, allowing many Americans to be exposed to second- and thirdhand smoke. As the Florida study suggests, increasing public knowledge about tobacco exposure is vital to address these issues. To best improve awareness, though, thirdhand smoke must be included.  

Click here to read the research study.

Additional Sources:

Dunlap C, Maness S, Larson D, Cheney MK. Residents’ Perceptions about Thirdhand Smoke in Multiunit Housing. Journal of Alcohol and Drug Education 2021;65(2):12-21.

Matt GE, Greiner L, Record RA, Wipfli H, Long J, Dodder NG, et al. Policy-relevant differences between secondhand and thirdhand smoke: strengthening protections from involuntary exposure to tobacco smoke pollutants. Tobacco Control. 2023. doi: 10.1136/tc-2023-057971.

Matt GE, Merianos AL, Quintana PJE, Hoh E, Dodder NG, Mahabee-Gittens EM. Prevalence and Income-Related Disparities in Thirdhand Smoke Exposure to Children. JAMA Netw Open. 2022 Feb 1;5(2):e2147184. doi: 10.1001/jamanetworkopen.2021.47184. PMID: 35129597; PMCID: PMC8822372.

Matt GE, Quintana PJ, Zakarian JM, Fortmann AL, Chatfield DA, Hoh E, et al. When smokers move out and non-smokers move in: residential thirdhand smoke pollution and exposure. Tob Control. 2011;20(1):e1. Epub 20101030. doi: 10.1136/tc.2010.037382. PubMed PMID: 21037269; PubMed Central PMCID: PMC3666918.

Record RA, Greiner LH, Wipfli H, Strickland J, Owens J, Pugel J, et al. Evaluation of a Social Media Campaign Designed to Increase Awareness of Thirdhand Smoke among California Adults. Health Commun. 2023;38(3):437-46. Epub 20210729. doi: 10.1080/10410236.2021.1954760. PubMed PMID: 34320896.

Rendón AD, Unger JB, Cruz T, Soto DW, Baezconde-Garbanati L. Perceptions of Secondhand and Thirdhand Smoke Among Hispanic Residents of Multiunit Housing. J Immigr Minor Health. 2017;19(1):162-9. doi: 10.1007/s10903-015-0309-7. PubMed PMID: 26545600; PubMed Central PMCID: PMC7447142.

Roberts C, Wagler G, Carr MM. Environmental Tobacco Smoke: Public Perception of Risks of Exposing Children to Second- and Third-Hand Tobacco Smoke. J Pediatr Health Care. 2017;31(1):e7-e13. doi: 10.1016/j.pedhc.2016.08.008. Epub 2016 Sep 27.


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