Inhaling second-hand and third-hand cigarette smoke poses health risks comparable to first-hand smoking, a pulmonologist warned Thursday and stressed that there is no safe level of exposure.

Dr. Corry Avanceña of Makati Medical Center addressed the issue during the End the Epidemic on Yosi, Vape, at Alak Among the Young media forum in Quezon City.

“The effects of the bad ingredients of cigarettes and vapes are inhaled by second-hand smokers,” Avanceña said and elaborated on the dangers of third-hand smoke, which lingers in environments where smoking occurs.

“But the third-hand smoke, as if you smoked in the room, it will stick to the floor, the wall. The child who crawls, it will stick to their skin. They will absorb it,” Avanceña said.

According to the Centers for Disease Control and Prevention, second-hand smoke exposure occurs when individuals breathe in smoke exhaled by smokers or from burning tobacco products.

Third-hand smoke, on the other hand, refers to the residual tobacco smoke that settles on surfaces, furniture and skin. The Lung Center of the Philippines (LCP) reports that it can be inhaled or absorbed through the skin.

The LCP has identified third-hand smoke as a significant health risk, particularly for children and nonsmokers.

Avanceña highlighted the vulnerability of pregnant women and their unborn children.

“For example, if a pregnant woman is exposed to someone smoking, the lungs of her fetus are affected,” Avanceña said. “We’re hoping that they can see that it’s not just the smoker, but also second-hand and third-hand smokers who are affected.”

The warning comes after the recent death of a 4-year-old boy from Mindanao, who developed pneumonia due to second-hand cigarette smoke exposure.

The child’s mother, who does not smoke, reported that numerous relatives, including the child’s grandfather and her brother-in-law, are smokers.