Home » Ky. initiative a model for addressing environmental tobacco residue’s effects on children

Ky. initiative a model for addressing environmental tobacco residue’s effects on children


The health of Kentucky does not rank high when compared to other states. Kentucky has the second-highest smoking rates for adults and pregnant women, rising obesity rates and the highest lung cancer rate in the U.S.

However, it is refreshing to discover that the Tobacco Program at the Lexington-Fayette County Health Department has become a national leader for third-hand smoke initiatives.

Providing education about ways to reduce the harmful effects of third-hand smoke has become a focus for Angela Brumley-Shelton, certified tobacco treatment specialist with the Lexington-Fayette County Health Department.

Third-hand smoke is the residue that remains on surfaces in areas where people have smoked. It is sticky and resists normal cleaning, and cannot be removed by air conditioners or fans. Cigarettes contain more than 7,000 harmful chemicals, including formaldehyde, arsenic, benzene and hydrogen cyanide, all of which are known to cause cancer. Many of these harmful chemicals can also be found in third-hand smoke. Exposure increases risk of childhood asthma and aggravates existing asthma and allergies.

Third-hand smoke clings to the clothes, skin and hair of a caregiver who smokes. It is particularly dangerous for infants because they are held close and then put their hands in their mouths after touching contaminated surfaces. Brumley-Shelton and her colleagues chose to focus on child care centers because if caregivers smoke, children are exposed to third-hand smoke throughout the day.

Brumley-Shelton’s first encounters with third-hand smoke was not only in scientific literature, but at her son’s child care center.

“When I picked up my son, he smelled like smoke,” she said. “Smoking wasn’t allowed in the day care, but teachers went to a picnic table behind the building to smoke. My son was having frequent breathing issues, sore throats and ear infections – I finally connected the dots.”

The innovative program she now leads is funded by state grants from the Kentucky Department for Public Health Tobacco Prevention and Cessation Program with a goal of increasing awareness of third-hand smoke and encouraging parents to seek 100 percent smoke-free child care.

The grant funds cessation classes and nicotine replacement therapy for staff from child care centers that become 100 percent smoke-free. Smoke-free centers have policies stating no smoking is allowed on center property, and employees may not leave the property or go
to vehicles during breaks to smoke. All of these regulations must also apply
to e-cigarettes.

The health department is providing 100 percent smoke-free signage to child care centers who have changed their policies. They are also creating an online list of these 100 percent smoke-free centers so parents and grandparents can be informed on choosing safer environments.

The “gold standard” for reducing third-hand smoke in child care policy is to include regulations that employees may not come to work smelling of smoke. However, the team from Lexington-Fayette County Health Department found that very few centers were 100 percent smoke free. They decided increasing the number of smoke-free centers was a better starting goal for the project.

Brumley-Shelton and her colleagues from the health department have presented their findings and experiences at local and national conferences. She explained that the more research about third-hand smoke is being done, but California and Maine are the only two states other than Kentucky that have attempted to address how it affects the health of
children in child care.   

Child care centers, parents, health department representatives and health care providers interested in more information may contact Angela Brumley-Shelton at (859) 288-2457 or visit lexingtonhealthdepartment.org.