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J Clin Outcomes Manag. 2017 Dec;24(12):551-559.

Guidance for the Clinical Management of Thirdhand Smoke Exposure in the Child Health Care Setting.

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Center for Child and Adolescent Health Research and Policy, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States.
Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States.



To explain the concept of thirdhand smoke and how it can be used to protect the health of children and improve delivery of tobacco control interventions for parents in the child health care setting.


Review of the literature and descriptive report.


The thirdhand smoke concept has been used in the CEASE intervention to improve the delivery of tobacco control counseling and services to parents. Materials and techniques have been developed for the child health care setting that use the concept of thirdhand smoke. Scientific findings demonstrate that thirdhand smoke exposure is harmful and establishes the need for clinicians to communicate the cessation imperative: the only way to protect non-smoking household members from thirdhand smoke is for all household smokers to quit smoking completely. As the scientific knowledge of thirdhand smoke increases, advocates will likely rely on it to encourage completely smoke-free places.


Recent scientific studies on thirdhand smoke are impelling further research on the topic, spurring the creation of tobacco control policies to protect people from thirdhand smoke and stimulating improvements to the delivery of tobacco control counseling and services to parents in child health care settings.


indoor air quality; pediatrics; smoking; smoking cessation; thirdhand smoke; tobacco


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