Published by authority of the Minister of Health
Cat. No.: H128-1/08-524E
HC Pub.: 4278
This guide is intended to help families remove second-hand smoke from their homes and cars. If you are a smoker, you may have heard that second-hand smoke is harmful to your family, but you may not be aware of the extent of harm it could cause. This guide will give you practical tips about what you can do to eliminate the harm caused by breathing in second-hand smoke in your home and car. Hopefully, it will raise new issues that you may not have thought about, help you talk to your family about smoking and ultimately rid your home and car of second-hand smoke.
In Canada, 15% of homes have at least one regular smoker,Footnote 1 and 25% of Canadians are exposed to second-hand smoke in a car or vehicle.1 Even in homes where regular smoking does not take place, 14% still allow smoking inside.Footnote 1
In 2006, over 350,000 (9%) of Canadian children under 12 years oldFootnote 2 and over 600,000 children between 12 and 19 years oldFootnote 3 were exposed to second-hand smoke in their homes from cigarettes, cigars or pipes. Although this number is dropping, it still means that almost one million children under 19 years old continue to be exposed regularly to second-hand smoke. If two parents smoked half a pack each a day in the home, in one year a child may be exposed to the smoke from over 7,000 cigarettes.Footnote 2
The good news is that most Canadian families agree they should avoid exposure to second-hand smoke in their homesFootnote 4 and in their cars.Footnote 5 Although less than half of Canadian homes (42%) place some restriction on smoking,Footnote 1 Canadian families agree they should avoid exposure to second-hand smoke in their homes.Footnote 4 Parents also report that the primary reason they want to cut back on the amount of second-hand smoke in their home is because of their children.Footnote 4
What do these statistics mean to you? Well, for one thing, they mean that you are not alone. Across Canada, hundreds of thousands of families are struggling with the issue of second-hand smoke and are looking for ways to protect children from its harmful effects. This guide has been developed to give families the tools they need to make their home and car smoke-free.
Did you know?
Second-hand smoke has been labelled as a "Class A" cancer-causing substance in the United States. Class A is considered the most dangerous type of cancer agent and there is no known safe level of exposure.Footnote 7
A non-smoker in a smoky room is inhaling the same chemicals as a smoker.Footnote 6
Some of the toxic and cancer causing agents found in second-hand smoke include asbestos, arsenic, and benzene.Footnote 10
Second-hand smoke contains the same 4,000+ chemicals that are inhaled by a smoker. About 50 of these chemicals are associated with, or are known to cause cancer.Footnote 9
Smoking in a closed-in space such as a car greatly increases the concentration of harmful chemicals produced by second-hand smoke.Footnote 8
Second-hand smoke is also known as environmental tobacco smoke (ETS) or passive smoke. Second-hand smoke is made up of:
« Second-hand smoke hurts everyone, but it is especially dangerous to little ones. »
Second-hand smoke affects your family members differently depending on their age and their health. There is no risk-free level of exposure.Footnote 11 Second-hand smoke hurts everyone, but it is especially dangerous to little ones because their lungs are still growing and developing. Because they are smaller, babies and children breathe more quickly and take in more harmful chemicals for their size than adults do. In addition, their immune systems, which protect them from getting sick, are less developed and can't protect them as much from tobacco smoke.Footnote 12
Second-hand smoke is even harmful to unborn babies.
Children don't have as much control over their world as adults do. Babies and toddlers can't complain about smoke. Even older children may not feel comfortable saying anything or trying to get away from the smoke. This is unfortunate because the health effects of second-hand smoke on children are much worse than on adults.
Many parents don't realize that second-hand smoke may harm their child's behaviour and ability to think things through (cognition). Children exposed to tobacco smoke score lower on tests than children who were not exposed to tobacco smoke.Footnote 16
Adult non-smokers who live with smokers also suffer the harmful effects of second-hand smoke.Footnote 11
Some studies have shown that second-hand smoke can cause leukemia (a type of cancer) in catsFootnote 19 and that dogs in smoking households have a greater risk of cancer.Footnote 20 And your furry friends don't just inhale smoke; the smoke particles are also trapped in their fur and ingested when they groom themselves with their tongues.Footnote 19
Many peoples are misinformed about how they can protect their families from second-hand smoke. Do any of these myths sound familiar?
Myth #1: If I smoke in another room, I'm not harming anyone.
The Truth: Second-hand smoke spreads from one room to another even if the door of the smoking area is closed. In addition, potentially toxic chemicals can cling to rugs, curtains, clothes, food, furniture and other materials and can usually remain in a room long after someone has smoked there.Footnote 21,Footnote 22,Footnote 23
Myth #2: If I open a window or turn on a fan in my home or car, I can get rid of most of the second-hand smoke.
The Truth: You may think that by opening a window or turning on a fan you are clearing the smoke from a room or your car, but that is not the case. Unfortunately, extensive studies have shown that there is no level of ventilation that will eliminate the harmful effects of second-hand smoke.Footnote 24,Footnote 25,Footnote 26 In addition, opening a car or room window can result in air flow back into the room or car which may cause the smoke to be blown directly back at non-smokers.Footnote 27
Myth #3: If I smoke when my children aren't home or in the car, it can't hurt them.
The Truth: Many parents think that it's all right to smoke when their children aren't around. What they may not know is that second-hand smoke lingers long after they finish a cigarette. Researchers found that second-hand smoke can remain in contaminated dust and surfaces, even if smoking took place days, weeks or months earlier.Footnote 21,Footnote 22,Footnote 23
Myth #4: If I use an air freshener or air filter, my second-hand smoke won't hurt anyone.
The Truth: Air fresheners only mask the smell of the smoke and do not reduce the harm in
any way. The sad truth is that even air filters (air purifiers) are not enough. Second-hand smoke is composed of both particles and gases. Most air filters are designed to reduce fine smoke particles in the air, but they do not remove the gases. This means that many of the cancer-causing agents in the gases remain.Footnote 26
«Work together to make your home and car smokefree. »
A Health Canada survey found that 36% of people who live in multi-unit housing experience smoke seeping or drifting into their personal living space usually through an open window or door from a neighbour's patio, balcony or outdoor common area.Footnote 28
Find information on making your building smoke-free.
What you can do to protect your family's unit from second-hand smoke.Footnote 29
Your first step will be to identify where the smoke is entering your home. Then, you or your landlord should:
Note: These actions may limit the flow of fresh air into your unit and should be taken only if you are experiencing extreme problems with second-hand smoke from your neighbours. It is advised that you talk to building management prior to making any modifications to your unit.
« There are many reasons why you should keep your home and car smoke-free. »
Beside the obvious health benefits, there are many other reasons why you should keep your home and car smoke-free.
The best way to protect your family from second-hand smoke is not to allow the smoking of cigarettes, cigars or pipes in your residence or car. It's that simple . . . and it's also that complicated. Getting through the process will be much easier if you make it a family project. Once you have made the decision to make your home and car smoke-free, you need to make a firm step-by-step plan and stick to it, even when your children aren't around. This guide will help you.
Your family is unique and ever-changing. Making your home and car smoke-free will be an ongoing project. If you are going to reach your smoke-free goal as a family, you must talk, as well as listen. Everyone will have to cooperate. Above all, be ready for challenges that will come up when you least expect them.
The first step toward protecting your family from the dangers of second-hand smoke is to call a family meeting to discuss making your home and car smoke-free. This meeting will give you an opportunity to talk openly about how you are going to work together.
Even before you actually meet, you may want to talk individually to family members. Show them
this guide and ask them how they feel about going smoke-free. This may help reduce their anxiety and will give you a chance to prepare for any problems that may arise.
If you smoke, be prepared to be honest with your family about the harmful health effects of smoking and second-hand smoke. If this upsets anyone, comfort them by telling them you are doing everything you can to stay healthy for them.
Try to set a time for your meeting when everyone is available. During the meeting, make sure that you reduce the number of distractions.
Make it very clear that the purpose of the meeting is to discuss going smoke-free at home and in your car. If there are other issues to discuss, ask that they be put aside until later in the meeting. During the meeting, get everyone's input, even those who may not agree with the decision.
During this step, it is important that you let everyone speak up about their feelings about making your home and car smoke-free. Write down the top five reasons why your family wants to have a smoke-free home and car.
Remember, this subject will be more difficult for members of your family who smoke, even if they are cutting back or trying to quit. If they are opposed to the idea, you will need to talk it through as a family. Listen to the reasons why they are opposed and show them the facts in this guide about the dangers of second-hand smoke. Remind them that living in a smoke-free home will increase their chances of successfully quitting.31 Be supportive, but firm about the whole family's right to live in a smoke-free home. Let them know how much you appreciate what they will be doing and offer to help in any way you can.
In this step, your family will need to discuss the difficulties in staying smoke-free and how to manage them. You may want to write down these challenges. If you understand everyone's feelings and are prepared, it will be easier to stay committed to a smoke-free home and car.
Here are some challenges you might face and how you might deal with them:
It's important not to leave small children alone when you go outside to smoke. You may want to consider making an arrangement with a neighbour or an older sibling to watch younger children while you are outside smoking. Cutting down on the number of cigarettes you smoke and how often you smoke may also make it easier to keep your home smoke-free. During those times, find ways to deal with the cravings, such as a breath mint or nicotine gum. Or take your children with you when you go outside to smoke. Try to make outdoor activity a regular part of your daily routine. Set a time to be outdoors and take your children for a walk or to play in the park.
Note: According to the Canada Safety Council, the legal age at which a child can be left alone for short periods of time varies from province to province and ranges between 10 and 12 years old.Footnote 33
Some people are uncomfortable asking friends or family to smoke outside because they feel it's impolite. Remember, these days, most people expect a smoke-free environment. As a result, most smokers are used to curbing their smoking when they are with other people. You may want to inform visiting family members and guests ahead of time that your family has made a decision to keep your home smoke-free. Tell them they are welcome to smoke outside. Remember, your family's health depends on this.
It is situations like this that will really test your resolve to keep your home smoke-free. If you are a smoker, one of the reasons you smoke may be to relax--the more stressful your situation is, the more you may want to smoke.
When confronted with these situations, remind yourself of the reasons why you chose to make your home smoke-free. Your child's health is very likely the number one reason why you chose not to smoke indoors. If a child is sick, it's even more important that you don't smoke in the house. Remind yourself that he will probably get better faster if you are not smoking inside the house.
This is a tough one. If a family member insists on smoking indoors, you will need to have an open and honest discussion about the problem. You may want to recruit the support of other family members and/or a neutral third party to help you. Explain how important it is that the whole family is protected from the harmful effects of second-hand smoke. Ask the smoker to try their best and reassure them that the whole family is there to help.
If it appears the smoker is not going to budge, as an absolute last resort, and perhaps as a temporary compromise, you should demand that the smoker restricts smoking to one room away from the children. If you live in an apartment with a balcony, ask the smoker to smoke there. Keep in mind that this will not eliminate your family's exposure to second-hand smoke.
If your family member is annoyed by having to go outside to smoke, remind them of the top five reasons for having a smoke-free home, or encourage them to quit completely. Find more information on quitting smoking.
«Ask the smoker to try their best and reassure them that the whole family is there to help. »
Today, parents tend to be quite willing to talk things out with their children. This honest and open approach encourages children to speak their minds.
Sometimes, the most powerful parent-child conversations take place in situations where you are
forced to be honest with each other. If you feel angry at your child for challenging you, stay calm. Take a few deep breaths and remind yourself that you agreed that your children have a right to a smoke-free home and that your child is simply asserting that right. By the same token, your child will also need to understand your perspective. Take some time to explain just how powerful your addiction to tobacco is. Be honest about your own worries and stresses. Use this as an opportunity to tell your child how much you hope they won't start smoking.
This one is even more difficult because, like most Canadians, your workplace is probably smokefree. Your commute to and from work may be one of the last places you can light up indoors. Your car is a direct extension of your home environment so you should follow the same rules that you use in your home. Remind yourself that due to the small interior space of the car, an increased concentration of smoke can be produced quickly and will cling to the upholstery and your clothing.
Instead of smoking in your car, try to leave home a few minutes earlier than usual to give you time for a cigarette outside before going into work. After work, take a few minutes to smoke outside before getting into your car.
An effective way to get everyone on board is to develop a family smoke-free pledge, which you can write down. Everyone should have a chance for input, including smokers and non-smokers, parents and children. Your pledge might say something like this:
Our family believes that everyone has a right to clean and fresh air. We pledge to do everything we can to make our home and car smoke-free.
Setting a date is also important. Don't put it off too long after your meeting. One week from your meeting date should give everyone time to get organized and to prepare to make your home and car smoke-free.
All the talking and planning in the world won't take the place of action. You need to show your family that you are serious and that you are following through on your decision to make your home and car smoke-free. Once your family has considered the challenges, written its pledge and set a date, it's time to decide as a family what you are going to do to make your home smoke-free.
Here are some specific actions your family can take:
In Your Home:
In Your Car:
You've done it! You've gone smoke-free! Now it's time to celebrate! Treat this like a special occasion. Think about things you do during these occasions and choose something everyone really enjoys. Here are some ideas for things you can do to reward your family for going smoke-free:
Don't forget to pay special attention to those family members who may have had a tougher time going smoke-free ... the smokers. They deserve a special reward!
Making your home smoke-free and keeping it that way will not be easy. It's a good idea to have a follow-up meeting after you have gone smoke-free to discuss how you are doing and whether or not any changes are needed.
If you need some help to stay on track, your Public Health Department should be able to provide support and assistance, and also refer you to other resources and agencies in your community that can help.
If you encounter serious family conflict issues over going smoke-free, you may want to contact your family doctor for help. You could also ask your family doctor to talk to members of the family about health concerns with second-hand smoke.
«We're ready to take the pledge.»
The Date We Will Go Smoke-free:
Our top 5 reasons for going smoke-free:
Challenges and how we will face them:
Post this on the fridge or bulletin board for everyone to see.
You are probably reading this because you are concerned that someone in your home smokes. You know that smoking is bad for your health and you may be worried that your parents might be harmed by their smoking.
The first thing to understand is that smoking is more than just a habit. It's a powerful addiction. Basically, that means it's really hard to quit. Your parents probably want to quit, but they are having a tough time with that. One thing you can be sure of though, your parents don't want you to get sick. They want to protect you from second-hand smoke. The good news is that there are things you can do to help and that by doing them, you may be able to provide just the support they need to eventually quit.
What should I say? Will my parents get upset? I just wish they would stop smoking. Why do they have to smoke around me?
Talking to your family about second-hand smoke won't be easy, but it will pay off in the end. Here are some tips that might help:
The best thing you can do is to work together with your family to ban all smoking in your home and family car. This guide can help your family set some rules about smoking. It also has tips on actions your family can take to limit smoking in the home and car, and keep it that way. Write a family pledge to go smoke-free and make sure you add your own reasons to the Top Five List.
Above all, remember that going smoke-free won't happen overnight. There will be challenging situations and probably a few setbacks. Sometimes, your parents might get angry and frustrated. If they do, be patient and respect that this is a difficult time for them. Talk to an adult, such as an aunt or uncle or teacher, and ask for help if you need to. Remember that you are a family and you all must work together to keep everyone healthy and happy.
Once you have established your smoke-free home and car, you may want to take it one step further. Here are some ideas for things you can do to keep the momentum going.
Tell your friends, family and neighbours about your decision to live in a smoke-free home and car. Be honest with them about the challenges and offer your support if they seem interested in doing the same thing.
Keep talking as a family. If you are going to stick to your decision, you will need to keep the dialogue going. Talk to your children about smoking and its harmful effects. Tell them about your own challenges with smoking and accept their help when they offer it.
If you live in a multi-unit housing complex, you may want to work with neighbours and the building owner to advocate for a smoke-free policy. These policies can govern a variety of spaces, including common areas, outdoor child play areas, apartments, and blocks or floors of units. Phase-in policies where units occupied by smokers are converted to smoke-free areas when they leave are also an option.
Steps to do this may involve:
Although this guide was not written with the intention of convincing you to quit smoking, now that your home and car are smoke-free, you may decide that this might be a good time to quit smoking for good.
You will find that living in a smoke-free home presents fewer cues and reminders to smoke and that quitting will be much easier than it has been in the past.Footnote 31
Talk to your doctor about options that can make it easier, such as the nicotine patch. Or call 1-800 O-Canada for a copy of On the Road to Quitting, Health Canada's guide to quitting smoking. In On the Road to Quitting, you'll find a list of the toll-free quit lines which are available in the provinces and territories to support you as you quit smoking.
For more information about second-hand smoke and quitting smoking, check out Health Canada's website: www.gosmokefree.gc.ca
Children, especially younger ones, rely on their parent(s) or guardian(s) to provide a safe and healthy home and car environment. By making your home and car smoke-free, you can protect your children from harmful second-hand smoke.
A smoke-free home and car means that NO smoking is allowed inside the home or car. This applies to all family members and visitors.
In order to help you create a healthy home environment, Health Canada has provided you with a few items that can be displayed in your home and car.
Note: If you're reading this guide online, you can order a paper copy to receive your magnet and decal.
Place this double-sided cling sticker on your car window or on a window in your home to let everyone know that your space is smoke-free. The material used in the cling sticker allows it to attach to a window without leaving a residue behind. You can attach and remove the sticker easily, and it's double-sided to ensure that those entering your home or car know that your space is smoke-free.
The attached fridge magnet turns into a magnetic picture frame once the inner piece is removed. You can insert a wallet size photo in the frame to create a personal reminder of why your home is smoke-free. Use the inner piece, which has useful information, as a separate magnet.
BONUS: check out page 29 of this booklet. You will find a smoke-free home and car pledge form that your family can fill in, cut out and post on a bulletin board or on your fridge.
PROTECT YOUR CHILDREN
MAKE YOUR HOME AND CAR SMOKE-FREE
DON'T LET YOUR CHILDREN BE A TARGET.
MAKE YOUR HOME AND CAR SMOKE-FREE.
Health Canada Website. Canadian Tobacco Use Monitoring Survey, Summary of Annual Results for 2006. Accessed December 13, 2007.
Health Canada Website, Canadian Tobacco Use Monitoring Survey Supplementary Tables. Table 9. Exposure of Children at home to Environmental Tobacco Smoke (ETS) by province and age group, Canada 2006. Accessed December 13, 2007.
Statistics Canada, Canadian Community Health Survey (CCHS 3.1), 2005. Exposure to second-hand smoke at home, by age group and sex, household population aged 12 and over, Canada, 2005. Accessed December 13, 2007.
EKOS, Phoenix Strategic Perspectives Inc. Baseline Survey of Parents on Second-hand Smoke in the Car and at Home. Report to Health Canada, March 2004, p. ii. Accessed December 18, 2007.
Ontario Tobacco Research Unit. The Smoke-free Ontario Act: Extend Protection to Children in Vehicles. OTRU Update, August 2006. Accessed December 13, 2007.
United States Environmental Protection Agency. (1992). Respiratory health effects of passive smoking: lung cancer and other disorders (p 3-2). Washington, DC: Indoor Air Division, Office of Atmospheric and Indoor Air Programs, Office of Air and Radiation.
U.S. Department of Health, Education and Welfare. (1979). Smoking and Health: A Report of the Surgeon General. Rockville, Md.: U.S. Department of Health, Education and Welfare, Public Health Service, Office of the Assistant Secretary for Health, Office on Smoking and Health.
Rees VW, Connoly GN. Measuring air quality to protect children from second-hand smoke in cars. American Journal of Preventive Medicine 2006;31:363-68. Accessed December 18, 2007.
U.S. Department of Health and Human Services. (1984). The Health Consequences of Smoking: Chronic Obstructive Lung Disease. A Report of the Surgeon General. Rockville, Md.: U.S. Department of Health and Human Services, Public Health Service, Office on Smoking and Health.
California Environmental Protection Agency. Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Sacramen to, CA: California Environmental Protection Agency, Air Resources Board and Office of Environmental Health Hazard Assessment, 2006. Part A: Exposure Assessment; Part B - Health effects; Part C - Public comments and ARB/OEHHA staff responses. Accessed December 18, 2007.
U.S. Dept. of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. Accessed December 18, 2007.
World Health Organization. Tobacco Free Initiative. International Consultation on Environmental Tobacco Smoke (ETS) and Child Health: Consultation Report. Geneva, Switzerland, 11-14 January, 1999. Accessed December 18, 2007.
Eliopoulos C, Klein K, Phan MK, Knie B, Greenwald M, Chitayat D, Koren G. Hair concentrations of nicotine and cotinine in women and their newborn infants. Journal of the American Medical Association, 1994;271:8.
Yolton K, Dietrich K, Auinger P, Lanphear BP, Hornung R. Exposure to environmental tobacco smoke and cognitive abilities among U.S. children and adolescents. Environmental Health Perspectives, 2005;113:98-103.
De Groh M, & Morrison H. Environmental Tobacco Smoke and Deaths from Coronary Disease in Canada. Chronic Diseases in Canada, 2002;23:13-16. Accessed December 18, 2007.
Moffatt RJ, Chelland SA, Pecott DL, Stamford BA. Acute exposure to environmental tobacco smoke reduces HDL-C and HDL2-C. Preventive Medicine, 2004;38:637-41.
Bertone ER, Snyder LA, Moore AS. Environmental tobacco smoke and risk of malignant lymphoma in pet cats. American Journal of Epidemiology, 2002;156:268-273.
Reif JS, Bruns C, Lower KS. Cancer of the nasal cavity and paranasal sinuses and exposure to environmental tobacco smoke in pet dogs. American Journal of Epidemiology, 1998;14: 488-492.
Singer BC, Guevarra KS, Hawley EL Nazaroff WW. Gas-Phase Organics in Environmental Tobacco Smoke. 1. Effects of Smoking Rate, Ventilation, and Furnishing Level on Emission Factors. Environmental Science & Technology, 2002;36:846-853.
Singer BC, Hodgson AT, Nazaroff WW. Gas-phase organics in environmental tobacco smoke: 2. Exposure-relevant emission factors and indirect exposures from habitual smoking. Atmospheric Environment, 2003;37:5551-5561.
Daisey JM, Mahanama KR, Hodgson AT. Toxic volatile organic compounds in simulated environmental tobacco smoke: Emission factors for exposure assessment. Journal of Exposure Analysis and Environmental Epidemiology, 1998;8:313-334.
Collishaw N, Meldrum H. Protection from second-hand smoke in Canada: Applying health science to occupational health and safety law. Ottawa: Physicians for a Smoke-Free Canada. 2003.
Repace J, Kawachi I, Glantz S. Fact sheet on secondhand smoke. 2nd European Conference on Tobacco or Health, 1st Iberoamerican Conference on Tobacco or Health. 1999.
Repace J. Risk management of passive Smoking. Saint Louis University Public Law Review, 1994;13:2.
United States Environmental Protection Agency. (1992). Respiratory health effects of passive smoking: lung cancer and other disorders (p 3-18). Washington, D.C: Indoor Air Division, Office of Atmospheric and Indoor Air Programs, Office of Air and Radiation.
Decima Research Report. Second Hand Smoke in Multiple Unit Residential Buildings. Prepared for Health Canada, March 2007. Accessed December 17, 2007.
Smoke-Free Housing Website. " What tenants need to know". Accessed December 19, 2007.
Clark PI, Schooley MW, Pierce B, Schulman J, Schmitt CL Hartman AM. Impact of Home Smoking Rules on Smoking Patterns Among Adolescents and Young Adults. Prev Chronic Dis. 2006 April; 3(2): A41. Accessed December 17, 2007.
Borland R, Yong H-H, Cummings KM, Hyland A, Anderson S, Fong GT. Determinants and consequences of smoke-free homes: findings from the International Tobacco Control (ITC) Four Country Survey. Tobacco Control 2006;15(suppl 3):iii42--iii50. Accessed December 17, 2007.
Young K, Regan M, Hammer M. Driver distraction: a review of the literature. Monash University Accident Research Centre. Report #206. 2003. Accessed December 13, 2007.
Canada Safety Council website. "Preparation and Communication the Key for Children Home Alone." Accessed December 19, 2007.
Beck P, Tilson M. When Neighbours Smoke: Exposure to Drifting Second-hand Smoke in Multi Unit Dwellings. Background Document: Nonsmokers' Rights Association, November 2006. Accessed December 18, 2007.