Why Are Smoke-free Environments a Big Deal? 

Millions of people — adults and children — are exposed to secondhand smoke. Sometimes, the smoke that poses a health threat comes from an adjacent housing unit such as another apartment or condominium unit. Smoke travels through walls, ventilation systems and hallways, which expose non-smokers to the same health threats faced by smokers. 

Many towns, states, casinos, medical centers, campuses and residential buildings are moving towards keeping all of their structures smoke-free, in an effort to reduce the amount of people exposed to tobacco smoke. This is especially helpful for children, who have still-developing lungs and are easily harmed by smoke exposure. 


  • Blood levels of cotinine, the typical marker of tobacco smoke exposure, are higher for children in non-smoking apartments than other non-smoking types of homes. This is most likely due to smoke from neighboring apartment units. 
  • Children exposed to tobacco smoke are at risk for asthma and other respiratory illnesses, earaches, and Sudden Infant Death Syndrome (SIDS). 
  • Some populations are more likely to become sick from smoke exposure such as children, the elderly, people with disabilities, or pregnant women. Some of these groups are also more likely to live in public housing buildings and can be easily exposed to smoke. 
  • The estimated cost of decontamination of a two-bedroom housing unit can be as much as $15,000. 
  • How far can tobacco smoke travel? Tobacco smoke can be measured in high quantities more than 20 feet from an outdoor source. 
  • Despite marketing claims, no ventilation system can protect from the death and disease caused by exposure to secondhand smoke. 
  • Some organizations are taking smoke-free laws even further: tobacco-free laws are gaining traction. These policies include products like electronic nicotine delivery systems (also called e-cigarettes) and smokeless tobacco like dip or chew. 

How Can Child Health Clinicians Help? 

American Academy of Pediatrics (AAP) policy recommends that child health clinicians support clean-air and smoke-free environment ordinances and legislation in their community and state, particularly for environments in which children live, learn, work and play, such as schools, multi-unit housing, public parks, child care settings, public beaches, sidewalks, restaurants and sporting arenas. These environments should be smoke-free even when children are not present. 
To aid in accomplishing smoke-free environments, child health clinicians can: 

  • Work with their AAP chapter to pass local and state legislation supporting smoke-free environments. 
  • Promote smoke-free homes and cars in all patient interactions. If quitting isn't possible, the only way to fully protect others from secondhand smoke is to maintain smoke-free homes and vehicles. 
  • Educate landlords and homeowners associations about the importance of maintaining smoke-free multi-unit housing environments. 

Smoke-free Environments Resources: 

Please note that these are not complete listings and inclusion in the listings does not imply endorsement by the Richmond Center or the American Academy of Pediatrics. 

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American Academy of Pediatrics