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Review

The Physical Processes and Chemical Transformations of Third-Hand Smoke in Indoor Environments and Its Health Effects: A Review

by
Yuyu Wang
1,2 and
Jianwei Gu
1,2,*
1
Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China
2
Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong Basic Research Center of Excellence for Ecological Security and Green Development, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
*
Author to whom correspondence should be addressed.
Atmosphere 2025, 16(4), 370; https://doi.org/10.3390/atmos16040370
Submission received: 20 January 2025 / Revised: 9 March 2025 / Accepted: 18 March 2025 / Published: 24 March 2025
(This article belongs to the Section Air Quality and Health)
Versions Notes

Abstract

:
Tobacco smoke is an important pollutant that causes over 8 million deaths each year, of which, 1.3 million deaths are attributed to second-hand smoke. Third-hand smoke refers to the chemical emitted from smoking that remains in the air, dust, and on the surfaces after smoking has stopped. These substances, which are deposited or adsorbed on indoor surfaces and dust and can be re-emitted into the indoor air continually, leading to human exposure over an extended period. The properties of the third-hand smoke chemicals and indoor surfaces are key factors influencing their indoor behaviors and human exposure. Additionally, the substances on surfaces can react with atmospheric oxidants to form secondary pollutants. For instance, nicotine in third-hand smoke reacts with atmospheric oxidants (ozone, nitrous acid, and hydroxyl radicals) to produce other toxic, carcinogenic substances, which may be more toxic, further increasing the risk to human health. This review aims to address three key questions: (1) What are the components of third-hand smoke? (2) How does third-hand smoke adsorb and desorb on/from indoor surfaces, and undergo chemical transformation? (3) How is exposure to third-hand smoke related to human health effects? Therefore, we conducted a comprehensive review of the chemical composition of third-hand smoke, its adsorption and desorption on indoor surfaces, chemical transformations indoors, and health effects, The chemical composition of third-hand smoke is complex, containing various toxic substances, carcinogens, and heavy metals. This review provided suggestions to prevent exposure to third-hand smoke.

1. Introduction

Tobacco is an important factor endangering people’s health [1], causing over 8 million deaths worldwide each year [2]. Tobacco smoke has a complex composition, containing various toxic chemical substances. Depending on whether the smoke is inhaled by smokers or non-smokers, it is divided into first-hand and second-hand smoke. First-hand smoke refers to the smoke directly inhaled by smokers (also called mainstream smoke), while second-hand smoke is the part of smoke exhaled by smokers and directly emitted from the cigarette tip during smoking (i.e., sidestream smoke) [3]. However, these two categories do not cover all aspects of tobacco smoke, particularly in indoor environments. The substances emitted from smoking can be adsorbed on indoor surfaces and dust. These substances can be re-emitted into the indoor air continually, even long after smoking has stopped [3,4,5,6,7]. These substances indirectly related to tobacco smoke are called third-hand smoke.
Third-hand smoke can be adsorbed on various surfaces in the indoor environment, including flooring, walls and wallpapers, furniture, appliances, toys, and textiles (e.g., clothing, carpets, curtains, towels, and sheets made from natural or synthetic materials) [8]. It can remain on surfaces for minutes to months or even years and is re-released into the air [9]. Many studies have found that volatile substances in cigarette smoke are enriched on the surfaces of various indoor materials, and some aldehydes, alkanoic acids, naphthalene, amines, and other compounds are released from the surfaces of different fabrics [9]. It has also been shown that about 60% of polycyclic aromatic hydrocarbons (PAHs), 70% of nicotine, and 80% of tobacco-specific nitrosamines in cigarette smoke adhere to indoor surfaces and cannot be removed under normal ventilation conditions [10]. Nicotine, a typical addictive compound in cigarette smoke, adheres to nearby object surfaces up to 90% [11]. Some of the compounds in third-hand smoke also undergo chemical reactions on material surfaces and are converted into more toxic chemicals, further exacerbating this potential risk. For instance, nicotine on object surfaces reacts with ozone, nitrous acid, and OH radicals to form various secondary pollutants [11,12]. These reaction products also pose potential health risks to humans.
Exposure to third-hand smoke can occur through ingestion, inhalation, and skin absorption. Among these, infants and young children are particularly vulnerable to third-hand smoke [12]. They may come into close contact with surfaces contaminated by cigarette smoke, such as furniture, toys, blankets and floors, while playing and crawling indoors, potentially absorbing chemicals through their skin. A recent study showed that when young children play indoors, PAH exposure through the hand-to-mouth pathway is approximately 2.5 times higher than that of adults [13]. As children breathe faster than adults, their per-body-mass exposure may be higher, and exposure to hazardous pollutants may cause more serious consequences during their developmental stage [9]. Therefore, it is necessary to understand the physical and chemical behaviors of third-hand smoke in indoor environments, as well as the resulting human exposure.
Third-hand smoke contains harmful and carcinogenic compounds. Since third-hand smoke chemicals remain in the indoor environment and on the surfaces of objects, their influence persists for months to years. Some of these chemicals can react directly with atmospheric oxidants on indoor surfaces to produce secondary pollutants [14,15,16,17,18]. The adverse health effects of smoking may stem not only from first- and second-hand smoke but also from third-hand smoke, which affects nonsmokers, especially women and children [19]. Therefore, it is important to understand how people are exposed to third-hand smoke.
Despite the review of third-hand smoke conducted by Matt et al. in 2011 [3], new findings on the composition of third-hand smoke have emerged. For example, furfural, pyrrole, biphenyl, and benzofuran have been discovered on the surfaces of clothing, and heavy metal elements like lead, cadmium, and PAHs have been detected on window and floor surfaces [8,20,21,22]. In addition, previous reviews primarily focused on chemical residues on indoor construction and decorative material surfaces, while knowledge of the adsorption and desorption of third-hand smoke on clothing and textiles in indoor environments remains scattered. Meanwhile, there have been new studies on the health effects of third-hand smoke. Therefore, we conducted a narrative review on the adsorption, desorption, and chemical transformation of third-hand smoke on indoor surfaces (with a focus on textiles), as well as the health effects resulting from various exposures. The aims of this review are to identify and summarize the chemical components of third-hand smoke, particularly focusing on their adsorption and desorption behaviors on indoor surfaces, especially textiles; investigate the chemical transformations of third-hand smoke components when they react with atmospheric oxidants and the resulting secondary pollutants; assess the health effects associated with exposure to third-hand smoke, particularly for vulnerable populations such as children and pregnant women; and propose effective measures to mitigate exposure to third-hand smoke in indoor environments.

2. Method

This review employed a systematic approach by entering keywords such as “third-hand smoke”, “chemical composition”, “adsorption”, “desorption”, “indoor surfaces”, “textiles”, “health impacts”, and “chemical transformation” into databases including Web of Science and PubMed. It identified peer-reviewed articles, experiments, and observational studies published over the past 20 years. Relevant literature focusing on the chemical composition of third-hand smoke, its adsorption and desorption on indoor surfaces, chemical transformation, and health impacts was selected, while studies not directly addressing third-hand smoke or lacking peer review were excluded. Data on chemical composition, adsorption/desorption mechanisms, chemical transformation, and health outcomes were extracted from the selected studies to ensure a comprehensive and transparent review of the third-hand smoke literature. Through a systematic analysis of these studies, we found that third-hand smoke poses significant health risks due to its complex chemical composition and long-term persistence in indoor environments.
Therefore, this review first examines the chemical composition of third-hand smoke, followed by an analysis of its adsorption and desorption processes on indoor surfaces, chemical transformations, and health impacts, concluding with a summary and outlook.

3. Chemical Composition of Third-Hand Smoke

First-hand and second-hand tobacco smoke consist of a complex mixture of gases and particles, containing over a thousand known chemical components [6]. These include nicotine, nitrosamines, benzo[a]pyrene (BaP), benzene, toluene, formaldehyde, acetaldehyde, acrolein, furans, pyridines, ammonia, hydrogen cyanide, 1,3-butadiene, fluoranthene, cadmium, and other compounds [14,23]. Many of these substances are volatile and semi-volatile organic compounds (VOCs and SVOCs), which can deposit on various indoor surfaces, particularly on clothing fabrics, and subsequently be reemitted into the air. Researchers have employed both experimental chamber and indoor field measurements to analyze the chemical residues on material surfaces and in the air. Studies have identified the chemical components of third-hand smoke residues on a variety of surfaces (including clothing, windows, floors, carpets, wallpapers, stainless steel, cotton towels, plastic toys, infant feeding bottles, and rubber pacifiers) (see Table 1). However, due to the varying objectives of these studies, only selected components on specific materials were measured, making it difficult to draw a systematic conclusion about the composition of the third-hand smoke.
When clothing fabrics were exposed to tobacco smoke in experimental chambers, multiple compounds were found to adsorb onto the fabric surfaces, including aldehydes, acids, alcohols, benzene derivatives, and PAHs [4,8,21,24]. Indoor field measurements have detected nicotine, PAHs, and nitrosamines on surfaces such as carpets, floors, windows, curtains, plastic toys, baby products, wallpaper, and stainless steel in smokers’ homes [6,10,22,25,26]. Notably, nicotine and the carcinogen 4-(N-methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) can persist on surfaces like carpets, curtains, and wallpapers for more than 50 days, while nitrosamines have been detected even after 111 days [4]. Wu et al. (2019) detected menthol in cotton fabric [24], which was attributed to the use of menthol-flavored cigarettes in the experiment. Additionally, Matt et al. (2020) identified heavy metals, including lead and cadmium, on floor and window surfaces, likely originating from cigarette smoke [22].
Furthermore, some researchers have employed advanced analytical techniques such as PTR-TOF-MS and GC-MS to characterize the organic components of third-hand smoke in indoor air [27,28,29]. Nicotine, ammonia, formaldehyde, and gaseous nitrosamines such as N-nitrosamines were detected in indoor air 12 h after smoking ceased [28]. After 18 h, compounds such as acetonitrile, 2,5-dimethylfuran, 2-methylfuran, acrolein, furan, acrylonitrile, 1,3-butadiene, acetaldehyde, toluene, and benzene were still detectable [27]. Sheu et al. (2020) studied the third-hand smoke in smokeless cinemas and identified 2,5-dimethylfuran, acrolein, 2-methylfuran, furfural, furfuryl alcohol, phenol, benzaldehyde, benzene, and toluene in the air [29]. These compounds have also been reported in other studies on third-hand smoke [8,21,24,30]. Although the concentrations of third-hand smoke substances in the air are significantly lower than those in second-hand smoke, they can persist for extended periods. For example, the total volatile organic compound (TVOC) concentration indoors was 4 mg/m3 20 min after smoking ceased but decreased to 0.2 mg/m3 after 18 h [27]. Nevertheless, third-hand smoke chemicals, particularly furans, acrolein, carbonyls, and nitriles, remain detectable in the air even after 18 h (e.g., acrolein at 2.4 μg/m3).
Through a combination of chamber experiments and in-situ measurements, it has been demonstrated that surfaces such as fabrics, carpets, floors, windows, curtains, plastic toys, baby products, and wallpapers can adsorb tobacco smoke constituents. Various compounds, including aldehydes, acids, alcohols, benzene derivatives, and PAHs, have been found to adsorb onto fabric surfaces. Residuals of nicotine, PAHs, and nitrosamines have also been detected on surfaces such as carpets, floors, windows, curtains, plastic toys, baby products, and wallpapers. Although the concentrations of chemicals in third-hand smoke are lower than in first-hand and second-hand smoke, they can persist indoors for much longer, posing a potential long-term health risk.
Table 1. Chemical composition of third-hand smoke.
Table 1. Chemical composition of third-hand smoke.
Air/Material SurfaceExperimental MethodAnalytical MethodChemical Components of Third-Hand SmokeReference
Air Indoor measurementGC-MSNicotine, ammonia, formaldehyde,
gaseous nitrosamine N-nitroso,		[28]
PTR-TOF-MS2, 5-dimethylfuran, acrolein, 2-methylfuran, furfural, furfuryl alcohol, phenol, benzaldehyde, benzene, toluene, 1-methyldodecylbenzene[21]
Chamber studyGC-MSAcetaldehyde, 1, 3-butadiene, acrolein, toluene, benzene, acetonitrile, 2,5 dimethylfuran, 2-methylfuran, furan, acrylonitrile[27]
Material surfaceCotton, linen, silk, acetate, polyesterChamber studyGC-MSAmmonia, 2-furan aldehyde, benzene, toluene, pyrrole[4]
Cotton, linen, wool, silk, rayon, polyester, acetate, synthetic, leatherChamber studySPME + GC-MSFormaldehyde, tetradecanoic acid, n-hexadecanoic acid, furfural, benzonitrile, naphthalene and capral aldehyde, phenol, styrene, ethylbenzene, benzofuran, naphthalene[8]
Cotton, filament, polyester, woolChamber studySPME + GC-MSBenzene, toluene, xylene, ethylbenzene, pyridine, naphthalene, furfural, nicotine[21]
Cotton, polyesterIndoor measurementGC-MS3-methylphenol, menthol, indole, nitrosamine[24]
Cotton towelChamber studyGC-MSNicotine, 3-vinylpyridine, furfural, furfuryl alcohol, phenol, 2-isopropyl -2, 3-dimethyl nitrile, benzonitrile[26]
Nicotine, NNN, NNK[10]
Plastic toys, baby bottles, rubber pacifiersChamber studyDCBI-MSNicotine, cotinine[25]
Curtains, wallpaperChamber studyGC-MSNicotine, nitrosamines[28]
Stainless steelChamber studyGC-MSPAHs, nicotine, NNN, NNK[10]
CarpetIndoor measurementPAH AnalyzerFluoranthrene, pyrene, Benzo (a) anthracene, anthracene[6]
Floors, windowsIndoor measurementLC-MSNicotine, lead, cadmium[22]

4. The Adsorption and Desorption of Third-Hand Smoke on Indoor Surfaces

The indoor environment is rich in various materials such as walls, furniture, carpets, curtains, clothing, and stainless steel, and the indoor surface-to-volume ratio is significantly larger than that of the outdoor atmosphere [31]. These surfaces have distinct chemical and physical characteristics, leading to variations in their adsorption and desorption properties for chemicals in tobacco smoke. These differences can significantly affect the concentrations and dynamics of these chemicals in indoor air, subsequently influencing human exposure.
Regarding the tendency of surface–air partitioning for a given pollutant, the partition coefficient is defined as the ratio of concentration on the material surface to its concentration in the surrounding air at adsorption–desorption equilibrium [32]. A larger partition coefficient indicates that pollutants are more likely to adsorb onto the material surface, while a smaller partition coefficient suggests that pollutants tend to remain in the air [33,34,35,36,37]. For the same pollutant, partition coefficients can vary widely across different materials. For example, the partition coefficients for diethyl phthalate (DEP) on glass (polished), stainless steel, and cotton clothing are 0.4, 3.0–3.5, and 209–411, indicating that textiles have a significantly higher adsorption capacity for DEP [36]. Morrison et al. exposed cotton undershirts, jackets, and jean fabrics to dibutyl phthalate (DnBP) in a chamber for 10 days [36] and estimated the partition coefficients of DnBP to be 3.6 × 106, 3.7 × 106, and 4.4 × 106, respectively. These values were much larger than the partition coefficient for DnBP on polyvinyl chloride (PVC) flooring, further highlighting the influence of material surface properties on pollutant adsorption [37].

4.1. Adsorption of Tobacco Smoke Mass and Specific Components on Materials

Many pollutants in tobacco smoke are VOCs and SVOCs. Several researchers have studied the adsorption of tobacco smoke components on common indoor fabric fibers, such as wool, cotton, linen, silk, acetate, and polyester [4,10,38]. For instance, after exposing 200 g of wool, cotton, and polyester fibers to tobacco smoke for 15 min, the fabric masses increased by 3.8 mg, 2.1 mg, and 0.4 mg, respectively (Table 2). Wool fibers adsorbed significantly more smoke mass than cotton and far more than polyester (approximately by a factor of ten) [38]. The adsorption capacity of materials for tobacco smoke may be related to their structural properties. Wool fibers have a unique cuticle structure with a higher surface area, providing more adsorption sites. Cotton also has a large surface area, while polyester fibers are relatively smooth and lack the complex structure of wool.
In addition to the adsorption of total tobacco smoke mass, the adsorption of specific chemical compounds has also been studied. Ueta et al. exposed several fabrics to tobacco smoke for 9 min, and found that ammonia, pyrrole, benzene, toluene, and other compounds were adsorbed on the surfaces of cotton, linen, silk, acetate fiber, and polyester fiber. Notably, high concentrations of ammonia (8.0–8.5 mg/m2) were adsorbed on cotton and linen fibers, while lower concentrations of benzene, toluene, and pyrrole (3.0–100 µg/m2) were detected on silk and polyester fibers [4]. In another study, Matt et al. placed cotton pillows in the homes of recent quitters (who had stopped smoking one week prior) and non-smokers (who had never smoked). After three weeks, no nicotine was detected on the pillow in the non-smoker’s home, whereas in the quitter’s home, nicotine concentrations in the pillowcase, pillow fabric, and pillow filling were 257 ng/g, 97 ng/g, and 17 ng/g, respectively [39]. Similarly, Min et al. found that nicotine and cotinine concentrations on the surfaces of infant rubber pacifiers exposed to third-hand smoke reached 327 μg/m2 [25]. These findings highlight the persistence of high concentrations of third-hand smoke contaminants on soft and porous materials.

4.2. Influencing Factors of Adsorption on Materials

The influence of the physicochemical properties of VOCs on their adsorption onto material surfaces has been investigated in several studies. Jan et al. found that gypsum board exhibited minimal adsorption for tetrachloroethylene (boiling point 121.2 °C), moderate adsorption for ethylene glycol monobutyl ether (boiling point 171 °C), and strong adsorption for 2,2,4-trimethyl-1,3-pentanediol diisobutyrate (boiling point 280 °C) [40]. This suggests that adsorption capacity increases with higher boiling points. Popa et al. confirmed that the adsorption capacity of painted gypsum board surfaces for compounds such as methylethylketone, isopropanol, and tetrachloroethylene increased as their vapor pressure decreased [41]. Similarly, Cox et al. found a positive correlation between the adsorption partition coefficient of VOCs on PVC floor tiles and their vapor pressure [42]. Additionally, the polarity of both the pollutant and surface material plays a role. Huang et al. investigated the adsorption behavior of polar and non-polar compounds on ceiling tiles and found that methanol, with the strongest polarity, exhibited the highest adsorption capacity, followed by semi-polar compounds like isopropanol and ethyl acetate. Non-polar compounds such as toluene and cyclohexane showed the lowest adsorption capacity [32]. These studies collectively indicate that the adsorption of VOCs on material surfaces is influenced by factors such as the boiling point, vapor pressure, and polarity [40,43].
Relative humidity (RH) also affects the adsorption of nicotine on certain materials. Destaillats et al. found that in dry air (0% RH), the adsorbed nicotine masses on cotton fabric and polytetrafluoroethylene surfaces were 12–18 mg/m2 and 0.4–0.8 mg/m2, respectively. At 65–70% RH, these values increased to 33–57 mg (on cotton) and 0.3–0.9 mg (on polytetrafluoroethylene) [5]. Thus, nicotine adsorption on cotton fabric surfaces was approximately three times higher at moderate RH (65–70%) than in dry air, while RH had a minimal effect on polytetrafluoroethylene. Petrick et al. observed that increasing RH from 5% to 50% significantly enhanced nicotine adsorption on nylon (from 4.04 to 2.1 × 104 mg/cm2). Wallboard paper, cotton, and wood surfaces exhibited higher adsorption capacities for nicotine under low RH, while smooth surfaces, like nylon, polyester, and glass, showed lower adsorption [44].
Exposure time to tobacco smoke also influences the concentrations of chemicals adsorbed on fabric surfaces. For example, when cotton and polyester fibers were exposed to cigarette smoke for 8 min and 10 min, respectively, the concentrations of chemicals such as furfural, 3-pyrrole, phenol, benzyl cyanide, naphthalene, and decanal released from cotton fibers were higher from the 10 min exposure [8]. This is because, before reaching adsorption–desorption equilibrium, longer contact times between fabric surfaces and cigarette smoke result in greater adsorption of chemicals.

4.3. Desorption Velocity from Indoor Surface and Influencing Factors

In indoor environments, chemicals from cigarette smoke can adsorb onto various surfaces and later desorb back into the air. The time required to reach adsorption–desorption equilibrium varies. Ueta et al. analyzed the desorption of smoke components in cars and found that benzene and 2,5-dimethylfuran reached equilibrium concentrations within 10 min (4 μg/m3), while toluene and xylene took approximately 20 min (10 μg/m3) [4]. Min et al. observed that nicotine concentrations on cotton clothing, glass, and filter paper stabilized after 20 min of exposure [25]. Borujeni et al. exposed textiles to cigarette smoke for 16 min, followed by a 15 min equilibration period, and found that the concentrations of VOCs released by cotton, wool, polyester, and silk were 92.37 mg/m3, 93.09 mg/m3, 87.88 mg/m3, and 50.22 mg/m3, respectively [21].
Relative humidity and desorption time have minor effects on the desorption capacity of chemicals from certain materials. For example, the mass of nicotine desorbed from cotton over one week was 12–16 mg in 0% RH and 11–15 mg at 70% RH. Similarly, the desorption rate of nicotine from polytetrafluoroethylene was comparable at different RH levels [5]. Borujeni et al. found that extending the desorption time beyond 15 min did not further reduce the concentration of organic compounds in the air, as most adsorbed chemicals are SVOCs that may take weeks, months, or longer to fully desorb [21].
In summary, during smoking, various chemicals, including nicotine and nitrosamines, adsorb onto indoor surfaces. Simultaneously, the desorption process releases these chemicals back into the air. The adsorption and desorption dynamics are influenced by the physicochemical properties of the adsorbates (e.g., boiling point, vapor pressure, and polarity), the properties of the surface materials (e.g., smoothness and polarity), and ambient relative humidity. Among these factors, the surface structure of materials has a pronounced impact on the adsorption and desorption of organic compounds from cigarette smoke. While relative humidity significantly affects nicotine adsorption, its influence on desorption is much smaller. Adsorption of tobacco smoke organics tends to increase with higher boiling points, although no specific relationship between boiling point and adsorption has been established in the context of cigarette smoke.

5. Chemical Transformation of Third-Hand Smoke

Ozone, OH radicals, and nitrous acid are common oxidants in indoor environments. Ozone primarily originates from outdoor infiltration and emissions from certain indoor electrical appliances [45]. Benzene, toluene, xylene, and limonene can be oxidized by ozone to form substances with lower volatility, leading to the formation of secondary organic aerosols (SOA) [46,47,48,49,50,51]. When VOCs and SVOCs adsorb onto indoor surfaces, they can react with oxidants to form secondary pollutants. VOCs such as 1,3-butadiene, styrene, benzene, toluene, and xylenes can be oxidized by ozone or OH radicals to produce formaldehyde, acrolein, benzaldehyde, and SOA. Specifically, the main products of the reaction between toluene and xylenes with OH radicals are glyoxal and methylglyoxal [46], while the primary products of the reaction between 1,3-butadiene and OH radicals or ozone are acrolein and formaldehyde [52]. Theoretical calculations by Wu et al. revealed that the oxidation of styrene by OH radicals produces formaldehyde and benzaldehyde [53]. It is worth noting that these volatile substances are also present in third-hand smoke, and they may react with atmospheric oxidants to generate secondary compounds. Currently, studies on the chemical transformation of third-hand smoke have primarily focused on nicotine.
Nicotine on indoor surfaces can react with indoor ozone. Tang et al. exposed polyester fibers to cigarette smoke and found nicotine and PAH concentrations of approximately 1 mg/m2 and 0.6 to 22 μg/m2, respectively. After introducing ozone, nicotine was no longer detected on the surface of the polyester fibers, and the PAH concentrations also dropped to background levels. Simultaneously, increased concentrations of formaldehyde, acetaldehyde, and acetone were observed, along with the formation of SOA [54]. The formation of SOA when ozone is introduced to exposed materials may be influenced by RH and the types of materials. Under dry conditions, the total particle number concentration (PNC) formed upon exposing nicotine–cellulose films and nicotine–cotton to ozone (55 ppb) was approximately 1.0 × 108 #/cm3. In a humid environment, the PNC formed on a cellulose membrane was approximately 1.0 × 108 #/cm3, while the PNC formed on cotton was approximately 1.0 × 106 #/cm3. Therefore, particle formation with cotton is significantly different under varying relative humidity, whereas the PNC formed with a cellulose membrane is less affected by humidity [55].
The reaction between ozone and nicotine on surfaces is influenced by the structure of the surface materials (see Table 3). Petrick et al. found that when paper and gypsum wallboard were exposed to cigarette smoke and then to ozone, the oxidation rate of nicotine on the paper surface was faster than that on the gypsum wallboard. This may be due to nicotine entering the pores of the gypsum wallboard, while the dense structure of the paper restricted the diffusion of nicotine. Cotinine, as the main product of nicotine ozonation, was detected on the surface of the paper material. Additionally, nicotine-1-oxide was discovered in the wallboard [18]. The ozonation process can substantially reduce the concentrations of harmful chemical substances adsorbed on indoor material surfaces. However, potential ozonation byproducts remain largely unclear and may pose risks to human health.
Gaseous nitrous acid (HONO) is an important indoor pollutant and an emerging household oxidant. It can be directly emitted into the environment through combustion processes, such as from candles, fossil fuels, biomass fuels, and gas stoves [56,57,58]. Studies have shown that when fabrics with adsorbed third-hand smoke are exposed to HONO for 3 h, the concentration of tobacco-specific nitrosamines (TSNAs) on their surfaces increases by more than 10 times. TSNAs mainly include 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK), N’-nitrosonornicotine (NNN), and 4-(N-methyl-N-nitrosamino)-4-(3-pyridyl)-1-butanal (NNA) [17]. TSNAs are mutagenic and carcinogenic. Notably, NNA is not present in second-hand smoke but is a reaction product of nicotine and HONO [58].
The OH radical is another oxidant in the atmosphere, which may form from the photolysis of ozone in the presence of water vapor, the photolysis of nitrous acid [57], and the reaction of indoor ozone with various alkenes [59,60,61]. Recent studies have revealed the role of OH radicals in the aging of cigarette smoke, producing low-concentration particulate matter and oxygen- and nitrogen-containing substances [62]. For example, Borduas et al. first reported the reaction of nicotine with OH radicals at room temperature, generating formamide and isocyanic acid (HNCO) [13], which provides a new perspective for understanding the transformation of nicotine in the atmosphere.
To summarize, the current literature indicates that nicotine can react with atmospheric oxidants and form a series of compounds, including formaldehyde, cotinine, creatine, N-methyl formamide, nicotine-1-oxide, tobacco-specific nitrosamines (NNN, NNK, and NNA), formamide, isocyanic acid, and increased PNCs. However, a comprehensive understanding of the oxidation of other tobacco smoke components is not yet available.
Table 3. Oxidation of nicotine in third-hand smoke and oxidation products.
Table 3. Oxidation of nicotine in third-hand smoke and oxidation products.
Compounds in Third-Hand SmokeOxidantProductsReferences
NicotineOzonen-Methylformamide, myoamine, nicotine-1-oxide[18]
formaldehyde, acetaldehyde, acetone, UFP[54]
myoamine, cotinine, SOA[55]
UFP[62]
HONO1-(n-methyl-n-nitrosamine)-1-(3-pyridyl)-4-butyraldehyde (NNA),[15]
4-(methyl nitrosamine)-1-(3-pyridyl)-1-butanone (NNK),[58]
n-nitroso-nornicotine (NNN)[17]
OH radicalformamide, isocyanate[17]

6. The Health Effects of Third-Hand Smoke Exposure

The health impact of third-hand smoke is a complex issue, encompassing a multitude of chemical substances, exposure routes, and health effects. Due to its ability to adhere to indoor surfaces and dust for extended periods, people may be exposed to these harmful substances in nonsmoking environments, particularly pregnant women and children, who may be more sensitive to the harmful substances in third-hand smoke. This may lead to health risks associated with long-term low-dose exposure. To comprehensively assess its health impacts, the effects of third-hand smoke on children, pregnant women, and fetal development, as well as long-term chronic health effects, should be considered from both epidemiological and toxicological perspectives.
The health effects of third-hand smoke exposure are summarized in Table 4. Firstly, due to frequent hand-to-mouth contact behavior and faster breathing rates, children are particularly susceptible to the impact of third-hand smoke, which significantly increases their risk of exposure to harmful chemicals. Researchers have detected cotinine in the urine and saliva of children who are exposed to third-hand smoke [63,64], indicating significant accumulation of nicotine and its metabolites in the body, further illustrating widespread exposure routes for third-hand smoke and potential bioaccumulative effects. Such exposure may lead to developmental delays and cognitive impairments. Furthermore, Carroquino et al. found that solid-state lead and cadmium in dust are residues of third-hand smoke, and exposure to these metals by children can lead to adverse neurobehavioral effects as well as endocrine and immune system disorders [65].
Similar to children, the effects on pregnant women not only concern the women themselves but also affect the health of their newborns. Studies have found that exposure to third-hand smoke during pregnancy may lead to issues such as low birth weight, preterm delivery, and abnormal fetal development [56,57,58]. Harmful substances such as nicotine and nitrosamines in third-hand smoke can cross the placental barrier, thereby affecting the normal development of the fetus. In addition, when pregnant women are exposed to third-hand smoke, the risk of postpartum depression significantly increases [56,57,58]. A study on the relationship between exposure to third-hand smoke during pregnancy and postpartum depression among Chinese women found that over 70% of women were exposed to third-hand smoke during pregnancy, and more than 17% of women experienced depressive symptoms after delivery [62], further exacerbating maternal and child health issues.
In addition to its impact on children and pregnant women, long-term exposure may lead to adverse health effects, including increased cancer risk, respiratory system impairments, cardiovascular system hazards, and digestive system disturbances. Specific components in third-hand smoke, such as formaldehyde and acrolein, can induce oxidative stress, leading to chronic inflammation and DNA damage, and thus elevating the risk of cancer [58]. Furthermore, the persistence of third-hand smoke in indoor environments exposes individuals to low doses of harmful substances over extended periods, resulting in cumulative health effects. For instance, nicotine, as a key component of third-hand smoke, is addictive and can stimulate the adrenal medulla to secrete adrenaline, leading to vasoconstriction and increased peripheral vascular resistance, which in turn triggers hypertension and other cardiovascular diseases [66]. Additionally, adult exposure to lead and cadmium may also result in cardiovascular diseases [67]. It was previously mentioned that cotinine was detected in urine and saliva. Cotinine, a metabolite of nicotine, has a half-life of approximately 18 h in the body and can reflect recent tobacco exposure levels; moreover, cotinine possesses potential mutagenicity and teratogenicity [68].
The nitrosamine compounds in third-hand smoke, such as NNN and NNK, are carcinogenic. NNN can confer mutagenic activity to human carcinogens, while NNK is a potent lung carcinogen that induces a large number of DNA adducts in the lung tissue of smokers, enhancing its carcinogenic effects [67]. Some scholars have conducted in-depth research on the toxic effects of NNK and NNN and found that NNN, when applied to the esophagus and nasal cavity of rats, can induce tumors in the lungs of mice and the trachea and nasal cavity of Syrian golden hamsters [69]. Regardless of whether administered orally, intraperitoneally, or through the lungs to rats, NNK can cause lung adenomas and adenocarcinomas, as well as nasal mucosa and liver cancers [69]. These findings further highlight the potential health threats posed by nitrosamine compounds in third-hand smoke.
Martins et al.’s research exposed mice to third-hand smoke, revealing profound impacts on mouse organs. For instance, the mice exhibited lower levels of fibrous collagen, skin wound healing times were extended, fatty degeneration of hepatocytes with elevated lipid levels, fatty degeneration was observed in hepatocytes, and excessive collagen and inflammatory cytokines were produced in the lungs, leading to inflammation-induced diseases [66,70]. Numerous studies have shown that third-hand smoke causes significant cellular changes. Hang et al. observed a significant increase in DNA strand breaks after exposing human HepG2 cells to an environment containing third-hand smoke for 24 h. Third-hand smoke can directly damage the genetic material of human HepG2 cells, resulting in DNA strand breaks; when HepG2 cells were exposed to NNA alone, the cell cultures exhibited more pronounced DNA damage, resulting in DNA single-strand breaks [58]. Subsequently, there was speculation about the potential effects of third-hand smoke on the reproductive system. Xu et al. exposed two different types of male germ cell lines (GC-2 and TM-4) to low concentrations of third-hand smoke for 24 h and observed significant changes in glutathione metabolism in GC-2 cells and nucleic acid ammonia metabolism in TM-4 cells, indicating that even exposure to low concentrations of third-hand smoke may alter the metabolic capacity of male germline cells [71]. Furthermore, Liu et al.’s research showed that NNA in third-hand smoke reduced the ovarian weight and the number of ovarian follicles in female mice [72], thereby threatening reproductive health.
Compared to first-hand and second-hand smoke, the concentration of third-hand smoke is relatively low; the chemical composition of third-hand smoke is complex and diverse, ranging from desorbed volatile and semi-volatile organic compounds to the secondary formed substances from oxidation. Many of the chemicals possess significant toxicity. Nicotine in third-hand smoke reacts with oxidants in the atmosphere to generate formaldehyde, cotinine, creatine, N-methylformamide, nitrosamines, formamide, isocyanic acid, and SOA, which may also adversely affect human health. For instance, formamide and isocyanic acid are reaction products of nicotine and OH radicals. Studies have reported that isocyanic acid can cause carbamylation, leading to rheumatoid arthritis, cataracts, and cardiovascular diseases [13,73,74,75]. SOA may induce respiratory diseases. Research indicates that ultrafine particles (UFP) within SOA can penetrate deep into the human respiratory system, adversely affecting human health. Long-term exposure to SOA can cause pulmonary inflammation and tissue damage, manifesting as enlarged lung cavities, recruitment of inflammatory cells, and changes in levels of inflammatory mediators. Furthermore, certain components in SOA, such as polycyclic aromatic hydrocarbons and organic amines, can induce oxidative stress and DNA damage, further increasing the risk of respiratory diseases [54].
In summary, the literature on this topic is limited, and these research findings indicate that third-hand smoke is responsible for various adverse health effects. Attention should be given to the hazards of third-hand smoke, and effective measures should be taken to reduce exposure. Therefore, we also propose two effective measures to control third-hand smoke contamination: (1) Enforce smoke-free environments in public places, and individuals should exercise self-restraint in their homes and vehicles to avoid contamination from the source as much as possible. (2) The substances in third-hand smoke on indoor surfaces are difficult to dissipate by natural ventilation, so furniture, carpets, wallboards, and other items contaminated by third-hand smoke should be cleaned or replaced; if necessary, repeated cleaning schemes can effectively remove newly accumulated contaminants.
Table 4. Health effects of third-hand smoke exposure.
Table 4. Health effects of third-hand smoke exposure.
Chemical SubstancesSite of ActionsTypes of Health EffectsReferences
NicotineAdrenal glandsElevation of blood pressure[66]
NitrosamineLungCause cancer[67]
Formamide, Isocyanic acidJointsEyes, heartRheumatoid arthritis
Cataracts and cardiovascular diseases		[13,73,74]
Lead and cadmiumHeart, neuronCardiovascular disease, bad neurobehavior[65,66]
CotinineUrine, salivaEndocrine, immune system disorders[68]
Third-hand smoke mixtureSkinWeak wound healing ability[66,70]
Liver cells, lungFatty degeneration, inflammation[70]
Human HepG2 cellsDNA damage[58]
Male reproductive systemChange germ cell line, metabolic ability[71]
NNAFemale reproductive systemDestroy follicles[72]
NNNEsophagus and nasal cavity of rats, lungs of mice, trachea and nasal cavity of syrian golden hamsterInduced tumor[69]
NNKLung, nasal mucosa, liverLung adenoma, nasal mucosa cancer, liver cancer[69]

7. Conclusions and Outlook

This review summarizes the chemical composition, physical processes, chemical transformation on indoor surfaces, and health effects of third-hand smoke. The chemical composition of third-hand smoke is complex and diverse, containing toxicants, carcinogens, and heavy metal elements. Its ubiquity and persistence have been confirmed in indoor environments, where chemical substances adsorbed on various surfaces continue to be released into the environment after smoking ceases. Chemicals in third-hand smoke, including nicotine, may undergo chemical reactions with ozone, nitrous acid, and OH radicals indoors, generating toxic and carcinogenic substances. People are exposed to third-hand smoke through multiple routes such as ingestion, inhalation, and skin absorption. Therefore, we have proposed effective measures to reduce third-hand smoke in indoor environments.
Despite extensive research on various aspects of third-hand smoke by many scholars, certain limitations remain. We identify three areas that require further study: When determining the chemical composition and exposure of third-hand smoke, previous studies focused on chemical substances adsorbed on indoor surfaces, but with few or no studies on the adsorption on skin and hair, which may be an overlooked route for exposure; when elucidating the chemical substances adsorbed on indoor material surfaces, there is a lack or no mention of material background as a control group, which can be improved in future studies; When studying the chemical transformation of oxidants and third-hand smoke, the focus was on the reaction of nicotine, with little research on the reaction of other components in third-hand smoke.

Author Contributions

Conceptualization, Y.W. and J.G.; methodology, Y.W.; software, Y.W.; validation, Y.W. and J.G.; formal Analysis, Y.W.; investigation, Y.W.; resources, J.G.; data curation, Y.W.; writing—original draft preparation, Y.W.; writing—review and editing, J.G.; visualization, Y.W.; supervision, J.G.; project administration, J.G.; funding acquisition, J.G. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the National Key Research and Development Program of China (grant number: 2022YFC3702602, 2023YFC3905102), the Guangdong Provincial Foundation for Basic and Applied Research (grant number: 2022A1515011213), and the National Natural Science Foundation of China (grant number: 42477430).

Conflicts of Interest

The authors declare no conflicts of interest.

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Table 2. Mass of third-hand smoke adsorbed on different material [38].
Table 2. Mass of third-hand smoke adsorbed on different material [38].
Material SurfaceMass Before Exposure (mg)Mass After Exposure (mg)
Wool fiber200203.8 ± 0.7
Cotton fiber200202.1 ± 0.55
Polyester fiber200200.4 ± 0.01
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MDPI and ACS Style

Wang, Y.; Gu, J. The Physical Processes and Chemical Transformations of Third-Hand Smoke in Indoor Environments and Its Health Effects: A Review. Atmosphere 2025, 16, 370. https://doi.org/10.3390/atmos16040370

AMA Style

Wang Y, Gu J. The Physical Processes and Chemical Transformations of Third-Hand Smoke in Indoor Environments and Its Health Effects: A Review. Atmosphere. 2025; 16(4):370. https://doi.org/10.3390/atmos16040370

Chicago/Turabian Style

Wang, Yuyu, and Jianwei Gu. 2025. "The Physical Processes and Chemical Transformations of Third-Hand Smoke in Indoor Environments and Its Health Effects: A Review" Atmosphere 16, no. 4: 370. https://doi.org/10.3390/atmos16040370

APA Style

Wang, Y., & Gu, J. (2025). The Physical Processes and Chemical Transformations of Third-Hand Smoke in Indoor Environments and Its Health Effects: A Review. Atmosphere, 16(4), 370. https://doi.org/10.3390/atmos16040370

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