Secondhand Smoke

Secondhand smoke (SHS) is a mixture of the smoke given off by the burning end of a cigarette, pipe, or cigar, and the smoke exhaled from the lungs of smokers.  The Surgeon General has documented that adverse health effects of secondhand smoke (SHS) exposure for non-smokers include:

  • Sudden infant death syndrome
  • Respiratory and ear infections
  • More frequent and severe asthma attacks among children
  • Coronary heart disease
  • Stroke
  • Lung cancer

There is no safe level of SHS exposure.

Secondhand aerosol (SHA) is exhaled by people who use Electronic Nicotine Delivery Systems (ENDS), such as e-cigarettes and vapes.  While SHA generally contains fewer toxins than SHS, the US Surgeon General has concluded that e-cigarette/vaping aerosol is not harmless. SHA may expose bystanders to harmful substances such as nicotine, heavy metals, ultrafine particulates, volatile organic compounds, and other toxins.

58 million Americans have been exposed to secondhand smoke.  Nearly half of those people are children between the ages of 3 and 19.  South Carolina data shows that 4 in 10 adults are deprived of the right to breathe clean air free from secondhand smoke and vaping aerosol in public places.  

Tobacco-Free and Smoke-Free Environments 

Division of Tobacco Prevention and Control staff work to build statewide partnerships resulting in initiatives that reduce exposure to SHS and SHA. Most comprehensive tobacco-free and smoke-free policies were enacted before the rise in ENDS product popularity and do not specifically prohibit the use of e-cigarettes or vapes.  Statewide tobacco-free efforts support the inclusion of ENDS products such as e-cigarettes and vapes.   

Clean air - free from secondhand smoke and vaping aerosol - remains the standard to protect health.

Cities, Towns, and Counties

Ordinances vary by municipality but generally prohibit the use of combustible commercial tobacco and other commercial tobacco products in public places, businesses (including restaurants), and some outdoor areas such as ballparks, stadiums, parades, or amphitheaters. 

County Map:  If you're looking to shop, eat or do business in a smoke-free environment, see the this map for information about towns, cities or counties that have adopted local commercial tobacco-free or smoke-free ordinances.


The Division of Tobacco Prevention and Control works to protect children from SHS and SHA exposure through the Clinical Effort Against Secondhand Smoke Exposure (CEASE).  CEASE SC engages pediatricians to screen for parental tobacco use when visiting with patients and their families.  Participating pediatricians provide support to parents who smoke commercial tobacco and help families establish rules for a smoke-free home and vehicle.

A Healthier State:  State Agencies

The Division of Tobacco Prevention and Control launched the A Healthier State:  Make Every Workday Great initiative in 2015 to address SHS and SHA exposure in the workplace at state agencies.  Technical assistance and education is provided to state agencies to help enact tobacco-free and smoke-free efforts. 

Non-Governmental Worksites 

The Division of Tobacco Prevention and Control has developed evidence-based strategies and resources to assist management and administrators interested in making their workplace smoke-free or tobacco-free. 

Behavioral Health and/or Substance Use Treatment Facilities 

People living with mental health conditions like depression and anxiety, or substance use issues are more likely to use tobacco and to suffer from tobacco-related health disparities.  Division of Tobacco Prevention and Control staff work with residential mental health and substance use treatment facilities across the state to provide tobacco cessation education and resources and provide technical assistance to help facility managers create a smoke-free and tobacco-free setting that meets the unique needs of their residents.

Parks and Recreation 

Everyone has the right to breathe clean air, especially when enjoying the outdoors.  Outdoor smoke-free laws are typically enacted by elected officials and local boards of health.  Division of Tobacco Prevention and Control staff provide education and awareness about the benefits of outdoor clean air protections to communities and organizations interested in smoke-free or tobacco-free outdoor settings.

Faith Based Organizations 

Since 2010, the Division of Tobacco Prevention and Control has supported the tobacco-free efforts of  Hold Out the Lifeline, a non-profit dedicated to faith-based health advocacy.  

Multi-Unit Housing 

SHS travels through ductwork, hallways, and windows—exposing residents in multi-unit housing to unwanted toxins.   In SC, over 206,000 multi-unit housing residents experienced SHS infiltration in their homes in the past year.  Division of Tobacco Prevention and Control staff provide education and resources to assist with smoke-free and tobacco-free policies in this setting.  Click here  to access a free guide to implementing smoke-free public housing policy. 

Looking to go smoke-free or tobacco-free?  Access examples of model tobacco-free and smoke-free policies for various settings 

Smoke-Free Palmetto State Certification  

Smoke-Free Palmetto State logo image

Local leaders committed to smoke-free protections from both secondhand smoke (SHS) and secondhand aerosol (SHA) from e-cigarettes deserve recognition for their dedication to the health and well-being of their community.  Smoke from cigarettes and cigars and aerosol from e-cigarettes/vape devices increase particulate matter in the air that can lead to severe asthma attacks, heart attacks, and lung cancer in non-smokers.  Certification requirements include:

  • Adoption and implementation of a comprehensive smoke-free ordinance providing protection from both secondhand smoke (SHS) and aerosol toxins from e-cigarettes/vapes
  • Applies to all indoor workplaces, restaurants, and bars
  • NO "grandfathering" - allowing existing workplaces to be exempt from the ordinance
  • NO waivers - allowing workplaces to apply for a waiver complying with the ordinance

Smoke-Free Palmetto_Lowcountry (pdf)

Smoke-Free Palmetto_Midlands (pdf)

Smoke-Free Palmetto_Pee Dee (pdf)

Smoke-Free Upstate (pdf)