Abstract
(1) Background: This narrative review examines in-vehicle tobacco smoke exposure among private, occupational, and commercial drivers, focusing on prevalence, nicotine biomarkers, and health consequences. (2) Methods: A comprehensive search on the PubMed, Scopus, and Embase databases was used to identify peer-reviewed, full-text, and English articles published between 2014 and 2024. Search terms were related to motor vehicles, tobacco smoke exposure, and drivers. Articles were selected for inclusion based on their relevance to in-vehicle smoking and second- or third-hand smoke exposure attributable to tobacco cigarettes through article title, abstract, and full-text screening. (3) Results: This review highlights the dangers of in-vehicle second- or third-hand smoke exposure, evidenced by the 17 articles included. Significant second-hand smoke exposure and biomarkers were revealed mostly among adolescents and children. However, a gap exists in addressing tobacco smoke exposure among occupational/commercial drivers, specifically, long-haul truck drivers (LHTDs), who have heightened exposure due to their work environment-the truck cabin-which may increase their lung cancer risk. (4) Conclusions: There is a significant literature gap regarding in-vehicle tobacco smoke exposure in occupational/commercial drivers. Future research should include nicotine biomarker usage to quantify nicotine exposures and smoking cessation intervention development tailored to LHTDs.