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The active threat from passive smoking

The active threat from passive smoking

It is important to remember that inhaling secondhand smoke is as dangerous as active smoking

Doctors say a passive smoker is equally exposed to the lung-damaging pollutants that an active smoker is inhaling

Doctors advised Hyderabad-based Aarti (name changed on request) to use inhalers when she complained of frequently running out of breath. But the 50-year-old would still wonder how she developed breathing issues despite being fit.

Then in March 2023, Aarti again felt short of breath, and also had fever and wet cough. This time her condition worsened over the next week.

She already had asthma, but a little digging into her lifestyle revealed that she had a chronic lung condition usually caused by cigarette smoking. While Aarti herself never smoked, she was a passive smoker.

“Aarti developed chronic obstructive pulmonary disorder (COPD) as a result of being exposed to cigarette smoke from her husband for over 35 years,” says Dr DS Sowjanya, a senior pulmonologist at Kamineni Hospitals, Hyderabad, who treated Aarti for COPD. “The husband used to sit beside her and smoke.”


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What is secondhand smoke?

According to Dr Sudarshan KS, consultant pulmonologist, Fortis Hospitals, Bengaluru, when someone breathes in smoke exhaled by a smoker or from burning tobacco products, they are exposed to secondhand smoke.

“Passive smoking, or breathing in secondhand smoke, involves inhaling smoke from lit cigarettes, biomass fuel exposure or exposure to air pollutants,” says Dr Sowjanya.

Is passive smoking worse than active smoking?

“A passive smoker is equally exposed to the lung-damaging pollutants which an active smoker is inhaling,” adds Dr Akash Deep Singh Arora, a consultant pulmonologist at Healthway Hospital, Old Goa.

The only difference between an active and passive smoker is that the effect of nicotine (which causes addiction to cigarettes) is lesser in passive smokers, according to Dr Sudarshan.

Initial exposure to secondhand smoke can cause coughing, redness and burning of eyes. Over a long duration, family members of active smokers are most at risk of developing conditions like COPD. “This can cause breathlessness on exertion, cough with mucus, and constant throat irritation in passive smokers,” says Dr Arora.

Effects of secondhand smoke

Experts list the following as the chief effects of passive smoking:

  • It puts you at risk of chronic lung conditions like lung cancer, asthma, COPD and bronchitis.
  • It increases the risk of exposure to many kinds of infections.
  • It can, over an extended period of time, lead to conditions like early brain degeneration, increased risk of stroke, eye problems, chronic nose and throat irritation, and throat cancer.
  • It can cause a decrease in appetite, just like in active smokers.
  • In children exposed to secondhand smoke, effects like sudden infant death syndrome (sudden and unexplained death of an infant), sudden asphyxiation (not being able to breathe) or acute lung injuries like bronchitis are commonly observed.

Secondhand smoke and pregnant women

Inhaled pollutants from secondhand smoke enter the bloodstream, and this can interfere with blood supply to the fetus.

“Exposure to secondhand smoke in the early stages of pregnancy can lead to spontaneous abortions, giving birth to babies with congenital disorders, and low-birth-weight babies,” says Dr Arora.

Duration of exposure matters

After initial withdrawal from passive smoking, the effects can be halted to some extent. “It might take a few months or years,” says Dr Sowjanya. However, the damage can’t be totally reversed in some cases as the effects depend on the intensity and duration of secondhand smoke.

“If it is not heavy exposure to secondhand smoke, and [if it is] for a short duration, preventing passive smoking can partially reverse some of the damage done, and gradually the lungs can revert back to normal,” adds Dr Arora.

The harm done due to passive smoking also depends on the ventilation in the area where one gets exposed to the secondhand smoke.

“Passive smoking in an open space (like the beach) will have a transient effect,” says Dr Arora. “However, the harmful effects of secondhand smoke in a confined room (like a closed office space) can linger on in the air for almost an hour.”


  • Passive smoking is primarily the inhalation of secondhand smoke from tobacco smoking. It can also be inhalation of air pollutants.
  • Passive smokers are equally exposed to lung-damaging pollutants as active smokers.
  • The effects of secondhand smoke mostly extend to family members of active smokers. Secondhand smoke can also have an adverse effect during pregnancy.
  • Depending on the intensity and extent of exposure, the effects of secondhand smoke can be managed in some cases.

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