No Safe Level of Secondhand Tobacco Smoke

Countries around the world are taking action to adopt smoke-free laws that ban smoking in all indoor public places, workplaces, and public transport.

Public health authorities worldwide have concluded that there is no safe level of exposure to secondhand smoke.1 Secondhand smoke causes serious diseases and premature death. Secondhand smoke has been proven to cause lung cancer, stroke, heart disease, sudden infant death syndrome, low birth weight, and serious respiratory conditions.2 Every year, exposure to secondhand smoke causes over 1.2 million premature deaths worldwide.3

The evidence is clear, there is no safe level of exposure to second-hand tobacco smoke. I urge all countries that have not yet done so to take this immediate and important step to protect the health of all by passing laws requiring all indoor workplaces and public places to be 100% smoke-free.Dr. Margaret Chan, Former Director-General, World Health Organization

The scientific evidence is clear that the only effective way to protect workers and the public from secondhand smoke is to implement comprehensive smoke-free environments by banning smoking in all indoor workplaces and public places, including restaurants, bars and other hospitality venues,4 as well as some outdoor spaces including educational and health institutions, and sports venues. Scientific evidence shows that other approaches, such as providing designated smoking areas and ventilation systems, do not protect against the health harms of secondhand smoke.4, 5

Smoke-Free Laws: Popular and Effective

Comprehensive smoke-free laws that ban smoking in public places have proven to be popular with the public,6, 7, 8 quickly improve health9, 10 and do not harm business.11

Article 8 of the WHO Framework Convention on Tobacco Control obligates Parties to the treaty to adopt effective smoke-free laws to protect citizens from exposure to tobacco smoke in workplaces, public transport and other indoor public places. Article 8 Guidelines make it clear that only comprehensive smoke-free laws that ban smoking in all indoor or enclosed public places, including workplaces, meet the treaty requirements.12 In 2004, Ireland became the first country to pass a comprehensive national smoke-free law. At least 60 countries and territories have passed comprehensive smoke-free legislation, including 39 low- and middle-income countries.13

1 World Health Organization. WHO Report on the Global Tobacco Epidemic 2009.
2 U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention 2014.
3 World Health Organization. Tobacco Factsheet. WHO May 2019.
4 International Agency for Research on Cancer. Evaluating the Effectiveness of Smoke-free Policies. World Health Organization 2009.
5 ITC Project and Tobacco Control Office, China CDC (October, 2017). ITC China Project Report. Findings from the Wave 1 to 5 Surveys (2006-2015). University of Waterloo, Waterloo, Ontario, Canada, and Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China.
6 ITC Project. Smoke-free Policies: ITC Cross-Country Comparison Report. Waterloo: University of Waterloo, 2012.
7 ITC Project. ITC Brazil Project Report - Findings from the Wave 1 and 2 Surveys (2009-2013). Waterloo: University of Waterloo, 2014.
8 Costa Rica Global Adult Tobacco Survey (GATS). Centers for Disease Control and Preventio, 2015. Available from:
9 Jones MR et al Cardiovascular Events Following Smoke-Free Legislation: An Updated Systematic Review and Meta-Analysis. Curr Environ Health Rep. 2014 Sep 1; 1(3): 239-249.
10 Faber T et al. Smoke-free legislation and child health. NPJ Prim Care Respir Med 2016 Nov 17; 26: 16067.
11 U.S. National Cancer Institute and World Health Organization. The Economics of Tobacco and Tobacco Control. National Cancer Institute Tobacco Control Monograph 21. NIH Publication No. 16-CA-8029A. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; and Geneva: World Health Organization, 2016.
12 Guidelines for implementation of Article 8 of the WHO Framework Convention on Tobacco Control. Protection from exposure to tobacco smoke. In: WHO Framework Convention on Tobacco Control: guidelines for implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article 13; Article 14 – 2013 edition.
13 Campaign for Tobacco-Free Kids Tobacco Control Laws Database.

Last updated June 4, 2019