Respiratory Health Effects of Passive Smoking (Also Known as Exposure to Secondhand Smoke or Environmental Tobacco Smoke ETS)

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In 1992, the EPA completed its risk assessment on The Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders (PDF, 525 pp, 4MB, About PDF) and concluded that the widespread exposure to ETS in the United States presents a serious and substantial public health impact.

More specifically, EPA concluded that ETS is a human lung carcinogen, responsible for approximately 3,000 lung cancer deaths annually in U.S. nonsmokers. Cover of the Second Hand Smoke or ETS Report

Furthermore, infants and young children are especially sensitive to ETS. In children, ETS exposure is causally associated with:
  1. an increased risk of lower respiratory tract infections such as bronchitis and pneumonia. (EPA estimates that 150,000 to 300,000 cases annually in infants and young children up to 18 months are attributable to ETS.),
  2. an increased prevalence of fluid in the middle ear, symptoms of upper respiratory tract irritation, and small reductions in lung function, and
  3. additional episodes and increased severity of symptoms in children with asthma. (EPA estimates that up to 1 million asthmatic children have their condition worsened by exposure to ETS.)

ETS exposure may also be a risk factor for the development of new cases of asthma. For more information, visit the home page on Asthma and Indoor Environments.


U.S. EPA. Respiratory Health Effects of Passive Smoking (Also Known as Exposure to Secondhand Smoke or Environmental Tobacco Smoke ETS). U.S. Environmental Protection Agency, Office of Research and Development, Office of Health and Environmental Assessment, Washington, DC, EPA/600/6-90/006F, 1992.

This document has been reviewed in accordance with U.S. Environmental Protection Agency policy and approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.