The Short Answer
A complete exposure history is more than “smoker or non-smoker.” It separates what you used (cigarettes, e-cigarettes/vapes, cigars, or pipe tobacco), how long and how often, and whose smoke or aerosol you breathed even if you never used a product yourself. Clinicians use this fuller picture to interpret symptoms, order the right tests, and talk through screening eligibility — and pack-year math alone leaves out vaping, cigars, pipes, and secondhand exposure entirely. Below is a worksheet you can fill out before a visit and bring with you, in your own words, without turning it into a self-diagnosis.
If You Have Any of These Symptoms Right Now
Get emergency care immediately, before filling out any worksheet, if you have severe shortness of breath, chest pain or pressure, coughing up blood, or sudden confusion. These are not exposure-history questions — they need urgent evaluation.
Why “Smoker” or “Non-Smoker” Isn’t Enough Information
Inhaled tobacco and nicotine products are not interchangeable, and neither is the smoke or aerosol that comes off them. Cigarette smoke, cigar smoke, pipe smoke, and e-cigarette aerosol have overlapping but distinct chemical profiles, and a person can be exposed to more than one type across their lifetime, including through someone else’s use. A clinician trying to interpret a cough, a screening eligibility question, or a pre-surgical risk conversation needs to know which of these applied, when, and how much — not just a single yes-or-no answer.
An Evidence Ladder: What’s Confirmed About Each Exposure Type
These are the points where federal health agencies have the strongest, most consistent evidence. Use this section to identify which categories apply to your own history.
Cigarettes
Cigarette smoke is the most heavily studied combustible tobacco exposure and the basis for most existing screening and risk tools, including pack-year calculations. If you have any history of cigarette smoking, note approximate start and quit dates (if applicable) and how many you typically smoked per day during different periods — this is the information a pack-year calculation needs, but your worksheet should keep it as a written history rather than a single number.
E-cigarettes and vapes
E-cigarettes (also called vapes) are battery-powered devices that heat a liquid to produce an aerosol, which users inhale and can also exhale into the surrounding air. Despite sometimes being called “vapor,” this aerosol is not harmless water vapor. According to the CDC, it can contain nicotine, ultrafine particles, flavoring chemicals such as diacetyl (linked to a serious lung disease), cancer-causing chemicals, volatile organic compounds, and heavy metals including nickel, tin, and lead. The CDC also notes that it can be difficult for users to know exactly what a given product contains, since some products marketed as nicotine-free have still tested positive for nicotine. E-cigarettes are not an FDA-approved method for quitting smoking. If you vape or have vaped, note the approximate start date, how often you use it, and roughly how you use it (occasional, daily, frequent through the day).
Cigars
According to the CDC, cigar smoke contains many of the same toxic and cancer-causing compounds found in cigarette smoke, and people who smoke cigars are exposed to nicotine and toxic chemicals even when they report not inhaling, since these substances are also absorbed through the lining of the mouth. The CDC lists cancer of the lung, throat, and mouth among the health risks of regular cigar smoking, along with increased risk of gum disease and, with heavy or deep-inhaling use, coronary heart disease. Note approximate frequency (occasional, weekly, daily), how many years, and whether you typically inhale.
Pipes
Federal fact sheets specific to traditional pipe tobacco are more limited than for cigarettes, cigars, or e-cigarettes. What’s established is that pipe tobacco is a burning tobacco product in the same general category as cigarettes and cigars — the CDC groups it with them when describing sources of secondhand smoke — so if you’ve smoked a pipe, it’s worth documenting the same way: approximate frequency, duration, and whether you typically inhale. If your use has involved a water pipe or hookah rather than a traditional tobacco pipe, note that separately. The CDC states that smoking hookah carries many of the same health risks as smoking cigarettes, and water pipe sessions are often longer than a single cigarette or cigar, which can mean heavier total smoke exposure per use.
Secondhand smoke (from any burning tobacco product)
Secondhand smoke is smoke from burning tobacco products such as cigarettes, cigars, or pipes. The CDC states there is no safe level of secondhand smoke exposure, and even brief exposure can cause serious health problems. It contains more than 7,000 chemicals, hundreds of which are toxic and about 70 of which can cause cancer. In adults who don’t smoke, it’s linked to coronary heart disease, stroke, and lung cancer; in children, it’s linked to more frequent ear infections, respiratory infections, asthma flares, slowed lung growth, and an increased risk of sudden infant death syndrome in infants. If you’ve lived with, worked closely near, or regularly ridden in a vehicle with someone who smoked, note the setting (home, workplace, vehicle), the approximate years, and whether it was daily or occasional.
Secondhand aerosol from e-cigarettes
People who use e-cigarettes near others can expose bystanders to some of the same substances found in the aerosol they inhale, including nicotine and heavy metals. This is a newer area of research than secondhand cigarette smoke, and the long-term health effects of secondhand e-cigarette aerosol exposure specifically are still being studied. If someone in your household or workplace vapes regularly indoors, note it the same way you would secondhand smoke.
Known vs. Still Being Studied
Separating these two categories keeps your worksheet accurate, not overstated.
Well-established, according to federal health agencies:
- There is no safe level of secondhand smoke exposure, and even brief exposure can cause serious health problems.
- E-cigarette aerosol is not harmless water vapor and can contain nicotine, heavy metals, and cancer-causing chemicals.
- Cigar smoke and hookah smoke carry many of the same health risks as cigarette smoke, including for people who don’t inhale deeply or use daily.
- Nicotine from any of these products is highly addictive and is a particular concern for adolescents, pregnant people, and fetal development.
Still being studied, or less thoroughly documented in federal sources:
- The long-term health effects of vaping, especially over decades of use, since e-cigarettes are newer than cigarettes and haven’t been tracked over an equivalent research timeline.
- How the health effects of exclusive, long-term e-cigarette use compare to cigarette smoking across specific diseases.
- The long-term effects of secondhand e-cigarette aerosol exposure specifically, as distinct from secondhand cigarette smoke.
- Traditional pipe tobacco specifically has less dedicated federal research coverage than cigarettes, cigars, or hookah use.
- The exact chemical contents of any single product, which can vary by brand, device, and batch.
Build Your Exposure History: A Worksheet You Can Fill Out
Work through each product type that applies to you. You don’t need exact numbers — approximate ranges are genuinely useful to a clinician.
- Product type(s) used: cigarettes, e-cigarettes/vapes, cigars, pipe tobacco, water pipe/hookah, or none of these, for each period of your life where use differed.
- Start and quit dates (or “still current”): approximate year is fine if you don’t remember the exact date.
- Typical amount and frequency: for cigarettes, roughly how many per day; for cigars and pipes, roughly how many per week or per day; for vaping, how many times a day you typically use the device.
- Inhalation pattern, where relevant: whether you typically inhaled deeply (more common with cigarettes and vaping) or not (more common, though not universal, with cigars and pipes).
- Secondhand exposure settings: home, workplace, vehicle, or social settings, with approximate years and whether exposure was daily, weekly, or occasional.
- Any periods of quitting and relapse: even short quit attempts are useful information, since cumulative exposure and years since your most recent quit both matter.
Bringing This to Your Health Visit
You don’t need to interpret this history yourself before your appointment — that’s the clinician’s job. Bringing a written record like this one simply means less time reconstructing details from memory during the visit itself, and more time on the parts of the conversation that actually need a professional’s judgment: whether further testing makes sense, what your options are if you’re still using any of these products, and what your personal risk picture looks like given your full history rather than just one product category.
If you’re in the process of quitting or considering it, our guide to what the first days and weeks of nicotine withdrawal can feel like covers what to expect without a fixed timeline. And if a cough or breathing symptom is part of why you’re bringing this history to a visit, this guide on smoker’s cough versus COPD symptoms explains what spirometry testing involves and when it’s worth asking about.
What This Worksheet Is Not
This is a way to organize your own history in plain language — it isn’t a pack-year calculator, a lung cancer screening eligibility tool, or a diagnostic checklist, and filling it out doesn’t tell you whether you qualify for a specific test or have a specific condition. Screening eligibility involves additional factors like your age and how recently you quit, and a clinician is the right person to walk through that with you using your complete history.
Medical Disclaimer
This article provides general educational information about tobacco and nicotine exposure history-taking. It is not medical advice, does not diagnose or treat any condition, and does not replace an evaluation by a licensed healthcare provider. If you’re experiencing severe shortness of breath, chest pain, coughing up blood, or other urgent symptoms, seek emergency care right away.
By SmokersLung.com Respiratory Health Education Team. Updated September 2026.