Passive Smoking and Its Effect on Lung Health

“What smoker does to himself/ herself maybe his business, but what they do to the non-smoker is quite a different matter.” – Roper Organization, 1978 (1).

With the advancement of technology, scientists started to discover the harmful effects of tobacco smoking that are not only limited to the smoker itself but also to those who inhale the cigarette smoke, better known nowadays as passive smokers.


What is passive smoker?


Passive smokers are those who breathe in other people’s tobacco smoke. It can increase a non-smoker’s risk of getting lung cancer and may also increase the risk of other cancers, including laryngeal (voice box) and pharyngeal (upper throat) cancers (nasopharyngeal cancer) (2).


Apart from cancer, the evidence is clear that second-hand smoke or passive smoking can also cause heart disease, stroke, and various complications of lung disease, the most common of which is Chronic Obstructive Pulmonary Disease (COPD) (2). Most harmful tobacco smoke is invisible but travels through the air and lingers; thus, it can also build up on surfaces and clothes, which explains why it is even more dangerous since people cannot see it and thus take no precaution for it when in fact it is still there and harming your body as you inhale it (2).


Passive smokers’ health


The first conclusive evidence on the dangers of passive smoking came from Takeshi Hirayama's 1981 study on lung cancer among non-smoking Japanese women who were married to men who smoked. Whenever passive smokers inhale the smoke from the burning tip of the cigarette (sidestream) and also whenever non-smokers breathe in the smoke that smokers inhale and exhale (mainstream), this will impose a 20–30% risk of getting lung cancer and a 23% higher risk of getting cardiovascular diseases on the non-smoker (3).


The smoke from cigarettes will do even more harm to children and pregnant women as compared to adults. As for children who are exposed to the smoke, they will have a higher risk of sudden and unexpected infant deaths, which include sudden infant death syndrome (SIDS) and fatal sleep accidents. Children who live in a smoking household for the first 18 months of their lives have an increased risk of developing a range of respiratory illnesses, including bronchitis, broncholitis, and pneumonia (4).


Children who are exposed to second-hand smoke are also more likely to get colds, coughs, and glue ear (middle ear infections). Their lungs are weaker and do not grow to their full potential. Which also explains that children who are exposed to second-hand smoke in the home are more likely to develop asthma symptoms, have more asthma attacks, and use asthma medications more often and for a longer period of time. As for the pregnant mother who is exposed to second-hand smoke, they have a higher risk of ectopic pregnancy, giving birth earlier (premature baby), and a lower birthweight (3, 4).


What can be done to improve this situation?


There are many things that can be done in order to improve this. As an example, from the government's and community's point of view, their role is to always create awareness about harmful second-hand smoke so that many more people are aware. The government can also implement health policies, such as in Australia, where it is illegal to smoke in a car with individuals below 18 years old; it is also illegal to smoke in an indoor workplace; and if individuals are to smoke, it has to be four metres away from the gate of a children’s indoor play centre, school, or kindergarten; if it is in an outdoor play park, it has to be 10 metres away from the play space, etc. While in Malaysia, it is illegal to smoke in the hospital area, school area, and certain public places such as restaurants (4).


Apart from this, the individual who is in contact with smokers, be it their family members, friends, housemate, partners, etc., must always voice their discomfort and their right to fresh air.


As for the smoker itself, after knowing the harmfulness of tobacco smoke, one should already try to quit smoking, not only for oneself but also for one's loved ones, for those who live with you and care for you. You may get help from the nearest community clinic for this; every government community clinic in Malaysia has a smoking cessation counsellor, doctor, and nurse who will help you with your addiction.



  1. World Health Organization (WHO). Passive Smoking Atlas. (Accessed on October 16, 2020)
  2. Cancer Research United Kingdom. What is passive smoker? (Accessed on October 16, 2020).
  3. Bek K, Tomaç N, Delibas A, Tuna F, Teziç HT, Sungur M. The effect of passive smoking on pulmonary function during childhood. Postgraduate medical journal. 1999 Jun 1;75(884):339-41.
  4. Victoria State Government. Better Health Channel. Passive Smoking. (Accessed on October 16, 2020).