Unveiling the hidden threats: second-hand and thirdhand smoke's impact on health – a systematic review

Cigarette smoking remains a significant global public health concern, contributing substantially to morbidity and mortality worldwide. This article examines the evolving understanding of the smoking epidemic, with particular emphasis on India, the world’s second-largest consumer of tobacco. Despite notable progress in tobacco control initiatives, substantial challenges persist. Exposure to secondhand smoke (SHS) and the emerging concept of thirdhand smoke (THS) present serious health risks, especially within domestic environments. Drawing on a synthesis of existing research, this paper explores perceptions of THS among the Indian population and identifies demographic factors influencing these perceptions. The findings indicate that older adults, females, individuals with higher levels of education, and non-smokers are more likely to recognize the adverse health effects associated with THS. Furthermore, the study highlights the significant public health risks posed by exposure to SHS and THS, emphasizing the heightened vulnerability of children. These findings underscore the urgent need for comprehensive smoke-free policies. The article recommends the implementation of targeted educational interventions, the strengthening of smoke-free regulations, and further research to better understand the health impacts of THS. Addressing THS alongside conventional tobacco control measures can enable policymakers and public health authorities to reduce tobacco smoke exposure and promote healthier environments for all.