Environmental Tobacco Smoke

This position statement was archived on 11/7/2012, because it is now a standard of practice.


  • The medical-surgical nurse should promote a smoke-free environment in health care settings and the community.
  • Nonsmokers have a right to a smoke-free environment in health care settings and the community.
  • The medical-surgical nurse should educate the public about the correlation between tobacco use of any form and the development or progression of respiratory disorders and cancer.
  • The medical-surgical nurse should assess the patient’s barriers to tobacco and smoking cessation and promote cessation strategies.
  • The medical-surgical nurse should participate in the world-wide No Smoke Day on May 31 each year.
  • The medical-surgical nurse should support legislation and regulations that promote tobacco and smoke-free environments.
  • The medical-surgical nurse will support initiatives of private organizations such as the American Lung Association in the global fight against tobacco use.


Tobacco is the single most preventable cause of death in the world, potentially linked to 6 million deaths each year. The death rate due to tobacco use is expected to exceed 8 million per year by the year 2030 (Ross, Mackay, Shafey, & Eriksen, 2009).

Tobacco contributes to respiratory, gastrointestinal, genitourinary, and reproductive cancer. It is the most significant risk factor for chronic pulmonary disorders, such as emphysema, chronic bronchitis, and asthma. Tobacco use potentates the development of arteriosclerosis, hypertension, and cardiac disease. Exposure to environmental tobacco smoke (ETS) causes disease and premature death in children and adults who do not smoke.


AMSN recognizes tobacco use and environmental tobacco smoke (ETS) are unsafe for all health care consumers. Smokers spend a large amount of money on tobacco that could be spent on food, health care, and other necessities (Ross et al., 2009).


Tobacco products are products made from the leaf of the tobacco plant which is intended to be smoked, sucked, chewed, or snuffed. All contain the highly addictive substance nicotine.

Environmental tobacco smoke (ETS), also known as second-hand smoke, is produced by the burning of tobacco via a pipe, a lit cigarette or cigar. ETS includes the smoke that is exhaled from the lungs of smokers. ETS can linger in the air hours after the smoking material has been extinguished.


American Heart Association (2009). Cigarette smoking and cardiovascular disease. Retrieved September 18, 2009, from http://www.americanheart.org/presenter.jhtml?identifier=4545

Centers for Disease Control and Prevention (n.d.). Current cigarette smoking habits: Summary health statistics for US adults: National health interview survey, 2008. Retrieved September 18, 2009, from http://www.cdc.gov/nchs/data/series/sr_10/sr10_242.pdf

Ross, H., Mackay, J., Shafey, O., & Eriksen, M. (2009). 2009 edition of The Tobacco Atlas catalogues catastrophic toll of tobacco worldwide. Retrieved September 18, 2009, from http://www.tobaccoatlas.org/tobaccoatlas/press.html

The American Lung Association. (2008). Tobacco policy project: State legislated actions on tobacco issues (SLATI). Retrieved September 18, 2009, from http://slati.lungusa.org