Comment: Second-hand smoke is a health problem for home care workers



STIRLING, UK: Imagine someone walking into a cafe, sitting at a table and lighting a cigarette.

In the UK – and other countries where smoking is banned in indoor public places – that would be almost unthinkable.

In the 15 years since the enactment of smoking bans across Britain, smoking indoors has gone from a reality to an aberration, and the health of the nation has only improved. . Strokes, heart problems and asthma attacks have all declined since the bans were introduced, especially among people who spent their working lives in smoky environments.

However, smoking is not prohibited in all workplaces, and many workers still breathe smoke when doing their jobs, such as craftspeople, caregivers and meter readers.

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In our recent study, we estimated that around 1 million UK workers are regularly exposed to secondhand smoke while working. Among these, those most seriously affected included home care workers – nurses, caregivers and other professionals who provide help at home to those who need it most.

During our research, we have seen these workers exposed to higher levels of smoke than you would find during smog in heavily polluted cities like Delhi.

These high levels of second-hand smoke could be a real problem. Even short periods of exposure to high levels of small particles (like those contained in secondhand smoke) have been linked to heart attacks and other circulatory problems in vulnerable people, as well as asthma.

(Photo: Unsplash / Patrick Brinksma)

In the longer term, regular exposure to smoke could increase the risk of heart disease, lung problems, and even stroke.

It seems like a bad reward for someone who spends their life caring for others. This is all the more true if we consider that caregivers are often poorly paid, coming from layers of society who already suffer from inequalities in health and whose life expectancy is shorter.


Many healthcare organizations, including the UK’s National Health Service (NHS), have policies designed to address these issues. This often involves asking clients not to smoke for an hour before a care worker arrives at their home.

However, we do know from our previous research that second-hand smoke can stay in a home at harmful levels for more than five hours after smoking a cigarette – one hour is not enough to clean the air. And even if it did, our research suggests that these guidelines are not being followed, with smokers turning on even when workers are at home.

The health of these workers is a source of serious concern. But there is a tension at the heart of this problem: When your workplace is someone else’s home, whose rights come first?

Smokers may choose to smoke at home, especially those with health and mobility issues (who are more likely to receive care) where it is difficult to get out.

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It is not good for their health (and certainly not for those who live with them) but it is their choice and their right. That said, if your job requires you to step into an environment and accept the health risks that come with it, don’t you deserve clean air like any other worker?

There is no clear and universally acceptable way to balance these two positions. But we need to think clearly about the risks and rights to find a way forward between these two competing ideas: the right to choose what you do at home versus everyone’s right to clean air at work.


The pandemic may have changed the solutions that people find acceptable. For example, people are now quite comfortable wearing masks indoors. It is possible that wearing high-quality N95 masks will reduce the number of smoke particles workers breathe to a level that leads to fewer health problems.

But it’s hard to do. Most of the thousands of chemicals in secondhand smoke cannot be filtered because they are gases rather than solid particles, so the World Health Organization says there is no such thing as a smoke level of safe tobacco.

However, for short visits, it could reduce the risk to a more acceptable level.

Other changes related to COVID could include a better understanding of the effect of ventilation. As it is increasingly understood that the virus is airborne, improving building ventilation has become a priority.

It can be difficult in older homes, but some studies have shown that using air purifiers helps combat small particles in homes – but these devices face the same issues as face masks and do little to remove harmful gases produced by smoking.

(What can be done to tackle the second-hand smoke problem of people puffing cigarettes next to an open window at home? In the latest episode of the Heart of the Matter podcast.)


If that doesn’t work, we might need a more drastic solution. Given the serious health effects of exposure to second-hand smoke and the nearly 800,000 premature deaths it causes worldwide each year, society may choose to reject the idea of ​​a “right to smoke entirely.” at home “.

After all, smoking is not essential, even for smokers, with nicotine substitutes and e-cigarettes widely (and cheap) available, and smokers in the UK are already required to keep cars private. smoke-free when children are traveling.

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Our perception of smoking in the presence of children is changing. In the future, we might consider smoking in the home unacceptable, given the toxic chemicals it releases into the air.

Smoke-free policies don’t just benefit people exposed to second-hand smoke, they often lead smokers to quit. Could all homes ever become smoke free?

This would not only benefit social workers, but also one in nine Scottish children currently living in smoky houses. It’s hard to imagine, but so were smoke-free pubs less than twenty years ago.

Ruaraidh Dobson is a researcher at the Institute for Social Marketing at the University of Stirling. Sean Semple is an associate professor at the same institute. This comment first appearance in The Conversation.


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