Exposure to environmental tobacco smoke (ETS) occurs when a person inhales tobacco smoke originating from the smoking of other people. Tobacco smoke is a mixture of over 4 000 chemical substances of which 40 are carcinogenic. ETS constitutes a serious but preventable cause of morbidity and mortality among exposed individuals.

According to previous epidemiological studies, exposure to ETS increases the risk of lung cancer (RR 1,17-1,25), acute event of coronary heart disease (25-35 % increase), asthma (OR 1,42-3,30), COPD (1,68-2,5) and respiratory infections (OR 2,5) in adults. Among children exposure to ETS leads to an elevated risk for respiratory symptoms such as wheezing (OR 1,47) and cough (1,67), asthma (OR 1,59). ETS causes also reduction of mean birth weight and risk of a preterm birth.

The tobacco legislation in Finland has been a powerful tool to reduce exposure to ETS. Since 1995 the Tobacco Act has especially had a significant impact on exposure to ETS in workplaces. The tobacco legislation has also influenced smoking habits. The prevalence of daily smokers has diminished and the number of cigarettes smoked during workshifts has also decreased significantly since the Tobacco Act was amended in 1995.

The role and attitudes of occupational safety and health (OSH) personnel, especially of physicians and nurses, is emphasized for successful implementation of the legislation on tobacco. Good practices of how to tackle the problems of ETS have to be included in the training of OSH personnel. To eliminate the exposure of people to ETS in workplaces, continuous occupational health consultations and active inspections by occupational safety inspectors are needed.