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Implementing smoke-free environments

11 December 2009 -- This episode focuses on the damage caused by second-hand smoke, and what some countries are doing to mitigate its harmful effects.

Transcript of the podcast

Veronica Riemer: You're listening to the WHO podcast. My name is Veronica Riemer. In this episode we look at the harm of exposure to second-hand tobacco smoke.

This week, WHO launches its 2009 report on the global tobacco epidemic. It gives not only details of the numbers of smokers by country but also what tobacco control measures each country is implementing – measures such as smoking bans in public places to provide smoke free environments, health warnings on tobacco products, bans on advertising, promotion and sponsorship and raising taxes and prices. WHO believes that governments should do more to shield their people from the harm of exposure to second-hand smoke and urges more countries to pass comprehensive smoke-free laws.

Dr Douglas Bettcher, Director of WHO's Tobacco Free Initiative, explains the real danger of exposure to second hand smoke.

Dr Douglas Bettcher: Second hand smoke is first of all, it kills, it is estimated that around 600 000 people die due to the exposure of second-hand smoke every year. Amongst adults, men and women, the exposure to second-hand smoke results in heart disease, heart attacks; it also leads to lung cancer. Also in children, boys and girls, we know that it causes sudden infant death syndrome, causes respiratory infections, bronchitis, inner ear infections. It is toxic; the smoke coming out of a cigarette that causes what we call this environmental smoke is as toxic or contains even more toxic substances than actually the smoke which is ingested by a smoker.

Veronica Riemer: Some of the best advances are taking place in Europe. Ireland, Turkey and the United Kingdom all have comprehensive bans on smoking in public places. Kristina Mauer-Stender, a tobacco control officer in WHO's Regional Office for Europe, explains the change and why leadership is an essential catalyst.

Ms Kristina Mauer-Stender: There is a trend (in WHO/Europe) that people want to be more healthy. They want to follow a healthy lifestyle. So it seems to be trendy, and people want to follow this trend. At the same time we can see in those countries which have made a lot of progress recently in terms of smoking bans that we have always had a leader or several leaders fighting for the smoking bans.

Veronica Riemer: In Turkey, one of the leaders has been Dr Elif Dagli, head of the department of pediatrics at Marmara University in Istanbul. For 22 years, Dr Dagli has worked to control the epidemic of tobacco use in Turkey. As chair of Turkey's National Coalition on Tobacco and Health, she successfully lobbied for Parliament to pass the country's comprehensive smoke-free law in 2007. She explains what the new law has meant for Turkey.

Dr Elif Dagli: All the public places – except for restaurants, bars and coffee houses – became smoke-free in May 2008, and 18 months after that restaurants and coffee houses and bars became smoke free. Since 19 July 2009, Turkey is a completely smoke-free country.

Veronica Riemer: But Dr Dagli says the law has not eliminated the risk to Turkish children, who are still exposed to smoke within their own family environment. Worldwide, half of all children are regularly exposed to second-hand smoke at home.

Dr Elif Dagli: In Turkey, culturally, people value their children so much, and then they come to the hospital. It is like a big crowd of adults together with only a small child –saying that we are so anxious about the health of our child, we want the child to improve and we can spend all our savings, we can sell our house and we want this child to get better. And then you examine the child and give information about the disease, prescribe some medicine. And then, when it comes to the smoking issue, you ask who else is smoking in the family. And then you find out that everybody in the house is smoking. Then you start giving them information about the health hazards of smoking. And they say that we will not be able to stop our smoking as we don't think that it is associated with our children's asthma attack.

If you would like to read the report or to obtain related information, there are links on the transcript page of this podcast episode. Look for the link to the podcast on the home page of our web site, at

That's all for this episode of the WHO podcast. Thanks for listening. If you have any comments on our podcast or have any suggestions for future health topics drop us a line. Our email address is

For the World Health Organization, this is Veronica Riemer in Geneva.

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