NEW DELHI: Even as the government is still deliberating on larger pictorial warnings on packs of tobacco products, 40% of Indian adults are exposed to second hand tobacco smoke at home .These are people who do not smoke themselves but are vulnerable to various diseases because someone smokes at home, showed a latest assessment by the World Health Organization , highlighting risks of second hand smoking and the need to warn people who smoke.Despite India’s regulation on public smoking, 30% adults are found exposed to second hand tobacco smoke at work, the study said.Experts say second-hand smoking is as harmful as tobacco smoking and there is an urgent need for public awareness as well as enforcement of existing laws and regulations. In India, smoke free public spaces cover health and educational facilities, public transport, government facilities and workplaces. However, designated smoking rooms in offices and restaurants not only create intense smoking environment but are also often attached to smoke free spaces.“There are architectural requirement that needs to be followed while creating even separate smoking rooms. For instance, there should be separate ventilation system,” said K Srinath Reddy, president, Public Health Foundation of India . He added, “There is conclusive evidence and there is no dispute that exposure to second hand smoking is harmful for health and can lead to respiratory problems in children, cancer and heart diseases in adults.”According to Dr Kewal Krishan, program in-charge heart transplant and ventricular assist devices at Max Hospital, passive or second hand smoking is particularly harmful to children and can significantly increase a non-smoker's risk of getting lung cancer.“It can damage lungs as second hand smoke contains over 4,000 chemicals, many of which are irritants and toxins and some of which are known to cause cancer,” said Dr Krishan. He added that second hand smoking may also cause fibrosis, which is a disease that causes scarring of lung tissue. As scars thicken, lungs slowly lose their ability to move oxygen into the bloodstream and fails to deliver oxygen to vital organs.Globally, second hand smoke is killing over six lakh people annually, including 1.65 lakh children before they reach their fifth birthday. According to WHO assessment, 46% of adults are exposed to second hand smoke at home in the South East Asia region.India and other countries need to strengthen their tobacco control policies, said Dr Thaksaphon Thamarangsi, director at WHO’s Department of Non-communicable Diseases and Environmental Health.Advocating smoke free public spaces to protect those who do not smoke, Dr Thamarangsi said joint government and public action is required to tackle the burden of diseases which can be otherwise prevented.“Government policies and programs must focus on informing masses about the ill-effects of tobacco use and effective measures like pictorial health warnings on tobacco products must depict heart disease and stroke as real dangers of tobacco use,”Dr Reddy said.Tobacco kills over 6 million people every year. Besides, 22% of global cancer deaths and 10% of deaths due to cardiovascular diseases are because of tobacco.