Health and Safety

Cigarette Smoking

Cigarette smoking is the leading preventable cause of death in the United States.

  • It harms nearly every organ of the body, causes many diseases, and diminishes the overall health of people who smoke.

  • Quitting smoking lowers your risk for smoking-related diseases and can add years to your life.
  • Cigarette smoking causes more than 480,000 deaths each year in the United States. This is nearly one in five deaths.

In January 2014, the Centers for Disease Control and Prevention (CDC) and the U.S. Surgeon General's Office released a report detailing the harmful effects of tobacco use. This report highlights 50 years of progress in tobacco control and prevention, and presents new data on the health consequences of smoking.

To learn more, download the full report or the executive summary:

Secondhand Smoke

  • There is no safe level of exposure to secondhand smoke. Each year in the United States, an estimated 7,300 adults who do not smoke die from lung cancer and 34,000 die from heart disease caused by secondhand smoke.
  • Secondhand smoke increases the risk for stroke by 20 to 30 percent, and causes more than 8,000 deaths from stroke annually.
  • Breathing secondhand smoke interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of having a heart attack. Even brief exposure to secondhand smoke can damage the lining of blood vessels and cause your blood platelets to become stickier. These changes can cause a deadly heart attack.
  • Thirdhand smoke is the chemical residue left behind by tobacco smoke. When a person smokes in a room, it can leave behind stale odor, or turn walls, carpets and other surfaces a sticky yellow. Over time, these surfaces can build up toxins. Children are at even greater risk than adults because they crawl on surfaces, wash their hands less, and are more likely to touch items that have germs.
  • Learn more about the health effects of secondhand smoke.


  • Nicotine, the most common active ingredient in vapor products, is highly addictive. Even without the smoke and tar of cigarettes, the nicotine itself can damage your heart, arteries, and lungs, increasing the risk for heart attack, stroke, and chronic lung disease.
  • Nicotine is worse for young people, whose bodies are still developing. Use of nicotine during adolescence and young adulthood has been associated with lasting cognitive and behavioral impairments, including effects on working memory and attention. According to the Centers for Disease Control and Prevention (CDC), nicotine can cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use.

Vapor Products

Because widespread use of vapor products is relatively new, there is much less information about the long-term health impacts of these devices compared to cigarettes and other tobacco products. That doesn't mean vapor products are healthy or safe. We do, however, know some short-term effects of vapor products and e-cigarettes, according to the National Academies of Sciences, Engineering and Medicine Public Health Consequences of E-Cigarettes report, 2016.

More information on the health effects of e-cigarette and vapor product use:

Besides nicotine, many other chemicals may be in e-liquid. These can include metals and formaldehyde. Because each manufacturer mixes its own liquid, it may not be clear exactly what is in it or what its health effects may be.

A lithium-ion battery is typically used to heat the liquid within the e-cigarette or vaporizer. This can pose a safety risk because the batteries have the potential to explode. Some of these explosions have caused serious injuries. The U.S. Fire Administration reports that between January 2009 and December 31, 2016, 195 separate incidents of explosion and fire involving an electronic cigarette were reported by the U.S. media.

Some people have used vapor products to try to quit smoking. However, the U.S. Food and Drug Administration has not approved vapor products as tobacco cessation devices.

  • Vapor products have the potential to benefit adults who smoke (and are not pregnant) if used as a complete substitute for regular cigarettes and other smoked tobacco products.
  • Vapor products are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.
  • While vapor products have the potential to benefit some people and harm others, scientists still have a lot to learn about whether vapor products are effective for quitting smoking.
  • Additional research can help understand long-term health effects.
  • If you've never smoked or used tobacco or vapor products, don't start.

People who wish to quit tobacco (or vapor products) should talk with their healthcare provider or call the Washington State Tobacco Quitline at 1-800-QUIT-NOW. More tobacco cessation resources

Pregnancies, Infants, and Children

  • Pregnancies

    • Women who smoke have more difficulty becoming pregnant and have a higher risk of never becoming pregnant.

    • Mothers who smoke are more likely to deliver their babies early. Preterm delivery is a leading cause of death, disability, and disease among newborns.
    • One in every five babies born to mothers who smoke during pregnancy has low birth weight. Mothers who are exposed to secondhand smoke while pregnant are more likely to have lower birth weight babies. Babies born too small or too early are not as healthy.
    • Both babies whose mothers smoke while pregnant and babies who are exposed to secondhand smoke after birth are more likely to die from sudden infant death syndrome (SIDS) than babies who are not exposed to cigarette smoke. Babies whose mothers smoke are about three times more likely to die from SIDS.
    • Vapor products should not be considered safe to use during pregnancy. Nicotine is a health danger for pregnant women and is especially harmful to a fetus. When a pregnant women uses nicotine — from either tobacco or vapor products — it can reduce the baby's growth, cause lungs or other organs to be underdeveloped at birth, and increase the chances of premature birth and birth defects. Also, some flavorings used in vapor products have been shown to be toxic to human embryonic stem cells.
    • Learn more about the health effects of smoking, and secondhand smoke on pregnancies.
  • Infants and Children
    • Because their bodies are developing, infants and young children are especially vulnerable to the poisons in secondhand smoke.
    • Secondhand smoke exposure causes acute lower respiratory infections such as bronchitis and pneumonia in infants and young children.
    • Secondhand smoke exposure causes children who already have asthma to experience more frequent and severe attacks.
    • The liquid nicotine used in vapor products is extremely poisonous, especially for young children. The Washington Poison Center reports calls to its hotline about nicotine exposures along with the popularity of vapor products.
    • Learn more about the health effects of secondhand smoke on infants and children.


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