​Tobacco Program

Smoking is the leading preventable cause of death in the United States.

Smoking causes more deaths each year than all of these combined7:

  • Human immunodeficiency virus (HIV)
  • Illegal drug use
  • Alcohol use
  • Motor vehicle injuries
  • Firearm-related incidents

Chemicals in tobacco smoke, and other places they are found

  • Acetone - found in nail polish remover
  • Acetic Acid - an ingredient in hair dye
  • Ammonia - a common household cleaner
  • Arsenic - used in rat poison
  • Benzene - found in rubber cement
  • Butane - used in lighter fluid
  • Cadmium - active component in battery acid
  • Carbon Monoxide - released in car exhaust fumes
  • Formaldehyde - embalming fluid
  • Hexamine - found in barbeque lighter fluid
  • Lead - used in batteries
  • Napthalene - an ingredient in moth balls
  • Methanol - a main component in rocket fuel
  • Nicotine - used as insecticide
  • Tar - material for paving roads
  • Toluene - used to manufacture paint

Secondhand Smoke FAQs

What is secondhand smoke?
According to the CDC, secondhand smoke is the smoke from burning tobacco products, such as cigarettes, cigars, or pipes. Secondhand smoke is also the smoke that has been exhaled, or breathed out, by the person smoking.1

What are the health effects of secondhand smoke?
The CDC states that there is no “risk-free” level of secondhand smoke exposure. Even being exposed to SHS for a brief period of time can be harmful to health.1

In children: Common effects on children include: ear infections, asthma attacks, respiratory symptoms (sneezing, coughing, and shortness of breath), respiratory infections (bronchitis and pneumonia), and a greater risk for Sudden Infant Death Syndrome (SIDS).

In adults: In adults who have never smoked, SHS can cause a greater risk for heart disease, lung cancer, or stroke.

EPA (Environmental Protection Agency) has concluded that exposure to secondhand smoke can cause lung cancer in adults who do not smoke. EPA estimates that exposure to secondhand smoke causes approximately 3,000 lung cancer deaths per year in nonsmokers.

The top three causes of lung cancer are smoking, radon, and secondhand smoke.8

What can you do?
The following is recommended by the CDC to protect yourself and your family from secondhand smoke1:

  • Quitting smoking if you are not already a nonsmoker
  • Not allowing anyone to smoke anywhere in or near your home
  • Not allowing anyone to smoke in your car, even with the windows down
  • Making sure your children’s day care center and schools are tobacco-free
  • Teaching your children to stay away from secondhand smoke
  • Being a good role model by not smoking or using any other type of tobacco

Other Tobacco Products

Juul Devices

JUUL devices heat up a cartridge containing oils to create vapor, which quickly dissolves into the air. The device is small enough to fit in a closed fist and has a sleek, tech-inspired design that resembles a USB flash drive, Juuls comes in flavors like mint, mango and crème brulee — which are proven to appeal to young people and facilitate initiation of tobacco product use. A single cartridge nicotine contents is roughly equal to a pack of cigarettes or 200 cigarette puffs. While e-cigarettes are less toxic than combustible tobacco products — still the leading cause of preventable disease and death in the country — there is a catch. Using e-cigarettes has been shown to increase the likelihood of smoking cigarettes among young people.

Other tobacco products (OTP) include non-cigarette tobacco products like cigars, little cigars and cigarillos, smokeless tobacco (chewing tobacco or snuff/snus), and dissolvable tobacco.

Non-Cigarette Tobacco Products
This category includes: cigars, bidis/kreteks, and hookah.2

Cigars contain the same toxic and carcinogenic compounds found in cigarettes and are not a safe alternative to cigarettes.2 A cigar is defined as a roll of tobacco wrapped in leaf tobacco or in a substance that contains tobacco (as opposed to a cigarette, which is defined as a roll of tobacco wrapped in paper or in a substance that does not contain tobacco).2 The three major types of cigars sold in the US include: large cigars, cigarillos, and little cigars.2

Bidis are small, thin, hand-rolled cigarettes imported to the United States, primarily from India and other Southeast Asian countries.4 Smoke from a bidi contains three to five times the amount of nicotine as a regular cigarette and places users at risk for nicotine addiction.4

Hookahs are water pipes that are used to smoke specially made tobacco that comes in different flavors, such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon.5 Hookah, although thought to be less harmful, can be just as harmful, or often more harmful than cigarette smoking.5 Hookah is often smoked in groups, and poses serious health risks to the smokers as well as others exposed to the smoke (secondhand smoke).

Smokeless Tobacco
According to the American Lung Association, smokeless tobacco is not a safe alternative to smoking cigarettes.3 It contains the same addictive substance (nicotine) that is in cigarettes, which can lead to addiction and dependence.3 The amount of nicotine absorbed from smokeless tobacco is 3-4 times the amount delivered by a cigarette!3

There are two main types of smokeless tobacco:

  • Chewing tobacco Comes in loose leaf, plug, and twist form.
  • Snuff/Snus Finely ground tobacco that can be dry, moist, or in bag-like pouches.

Most smokeless tobacco users place the product in the cheek or between their gum and cheek, suck on the tobacco and spit it out or swallow the juices...which is why smokeless tobacco is often referred to as "spit."3

Electronic Nicotine Devices (END)

New devices continue to be marketed. Left to Right: E-cigarettes, Hookah Pens, Vape Pens, E-hookahs, E-cigars, E-pipes

Electronic nicotine devices are battery powered devices that heat liquids that contain nicotine to produce aerosol that is inhaled by the user.

Manufacturers claim that electronic cigarettes are a safe alternative to conventional cigarettes. However, the Food and Drug Administration (FDA) has questioned the safety of these products and do not recommend their use as a cessation tool.

When the FDA analyzed samples of two popular brands, it found variable amounts of nicotine and traces of toxic chemicals, including known cancer-causing substances (carcinogens).6 This prompted the FDA to issue a warning about potential health risks associated with electronic cigarettes.6 Until more is known about the potential risks, the safe play is to say no to electronic cigarettes.6

Visit our smoking cessation page to learn more about quitting smoking/tobacco products.


  1. Secondhand Smoke (SHS) Facts. (2015, February 6). Retrieved April 2, 2015, from
  2. Cigars. (2013, November 14). Retrieved April 2, 2015, from
  3. Smokeless Tobacco Products - American Lung Association. (n.d.). Retrieved April 2, 2015, from
  4. Bidis and Kreteks. (2013, July 9). Retrieved April 2, 2015, from
  5. Hookahs. (2013, December 17). Retrieved April 2, 2015, from
  6. Quit smoking. Retrieved April 2, 2015, from
  7. Health Effects of Cigarette Smoking. (2014, February 6.) Retrieved April 2, 2015, from
  8. Juul Truth Initiative. 2018, February 5). Retrieved July 20, 2018 from

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