Secondhand Smoke: Worker Health

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The 2006 U.S. Surgeon General's Report on The Health Consequences of Involuntary Exposure to Secondhand Smoke has concluded that 100% smokefree workplace policies are the only "effective way to eliminate secondhand smoke exposure in the workplace."

As of July 2011, hundreds of communities, 23 states, Washington D.C., Puerto Rico and the U.S. Virgin Islands have strong 100% smokefree laws in effect to protect worker health in all non-hospitality workplaces and restaurants and bars. However, the workplace remains a major source of exposure to secondhand smoke for millions of Americans. More than half of the U.S. workforce remains unprotected by a local or state smokefree law for all workplaces.1,2

The World Health Organization (WHO) recommends that legislation be enacted to require that all indoor workplaces and public places be 100% smokefree in order to protect the health of all workers.3

Nonsmokers and former smokers who are exposed to secondhand smoke in confined workplaces display a significant increase in DNA damage associated with a decrease in DNA repair capacity.4

New York State's clean indoor air law caused a reduction of secondhand smoke exposure in nonsmoking workers, with saliva cotinine levels decreasing by 47.4 percent. Cotinine is a metabolite of nicotine.5

Hospitality Workers

Hospitality worker health improves dramatically with the passage of smokefree laws.

Blue-Collar Workers


May be reprinted with appropriate attribution to Americans for Nonsmokers' Rights, © 2011.


  1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
  2. American Nonsmokers' Rights Foundation, "U.S. 100 percent smokefree laws in workplaces and restaurants and bars," American Nonsmokers' Rights Foundation,, July 1, 2011.
  3. World Health Organization (WHO), "Protection from exposure to secondhand smoke: policy recommendations," World Health Organization (WHO), 2007.
  4. Fracasso, M.E.; Doria, D.; Franceschetti, P.; Per bellini, L.; Romeo, L., "DNA damage and repair capacity by comet assay in lymphocytes of white-collar active smokers and passive smokers (non- and ex-smokers) at workplace," Toxicology Letters 167(2): 131-141, December 1, 2006.
  5. Bauer, U.; Juster, H.; Hyland, A.; Farrelly, M.; Engelen, M.; Weitzenkamp, D.; Repace, J.; Babb, S., "Reduced secondhand smoke exposure after implementation of a comprehensive statewide smoking ban - New York, June 26, 2003-June 30, 2004," Morbidity and Mortality Weekly Report 56(28): 705-708, July 20, 2007.
  6. RTI International, "First Annual Independent Evaluation of New York's Tobacco Control Program," New York State Department of Health, November 2004.
  7. Farrelly, M.C.; Nonnemaker, J.M.; Chou, R.; Hyland, A.; Peterson, K.K.; and Bauer, U.E., "Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law," Tobacco Control 14(4): 236-241, August 2005.
  8. Palmersheim, K.A., et al., "Madison Bartenders Baseline Survey: Preliminary Findings - Brief Report," Tobacco Surveillance & Evaluation Program, University of Wisconsin, Comprehensive Cancer Center, September 2005.
  9. Palmersheim, K.; Wegner, M.; Remington, P., "Health effects of smoke-free bars in Wisconsin," Wisconsin's Comprehensive Cancer Control Program Surveillance Brief 3(1), April 2007.
  10. Palmersheim, K.A.; Pfister, K.P.; Glysch, R.L., "The impact of Wisconsin's statewide smoke-free law on bartender health and attitudes," University of Wisconsin, Milwaukee, Center for Urban Initiatives and Research, [2011].
  11. Pierce, J.P.; Leon, M.E., "Special report: policy - effectiveness of smoke-free policies," Lancet Oncology 9: 614-615, July 2008.
  12. Building Trades Unions Ignite Less Tobacco [BUILT] Project, "Unions yes [and] tobacco no," California: Department of Health Services, 2001.
  13. Clark, III, J.D.; Wilkinson, J.D.; LeBlanc, W.G.; Dietz, N.A.; Arheart, K.L.; Fleming, L.E.; Lee, D.J., "Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers," American Journal of Industrial Medicine 51(8): 626-632, May 14, 2008.