Trends in Secondhand Smoke Exposure Among U.S. Nonsmokers Trends in Secondhand Smoke Exposure Among U.S. Nonsmokers
Centers for Disease Control and Prevention

Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from secondhand smoke exposure.

A year ago, on June 27, 2006 , the Surgeon General’s Report on The Health Consequences of Involuntary Exposure to Tobacco Smoke was released. The report concluded that secondhand smoke causes premature death and disease in children and nonsmoking adults, and that there is no risk-free level of secondhand smoke exposure. The report also found that secondhand smoke exposure fell by 70% from 1988–1991 to 2001–2002 and that the proportion of nonsmokers was halved over that period, from 88% to 43%.

Secondhand Smoke Exposure in Homes and Workplaces

More than 126 million nonsmoking adults and children in the United States continue to be exposed to secondhand smoke. The two major settings where exposure occurs are the home and the workplace, with the home being the primary source of exposure for children. Secondhand smoke exposure also continues in public places such as restaurants, bars, and casinos, and in vehicles.

The report found that eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from secondhand smoke exposure. Other approaches, such as no smoking sections and ventilation, are not effective. In addition to protecting nonsmokers, the evidence also suggests that smoke-free environments in workplaces, public places, and homes help smokers quit and reduce smoking initiation among youth. The proportion of US households with smoke-free home rules (voluntary household rules not allowing smoking in any part of the home at any time) increased from 43% in 1992–1993 to 72% in 2003.

The 2006 report has had a major impact on policy decisions in both the public and private sectors. The report has contributed to the enactment of smoke-free laws in numerous states and local jurisdictions. In part because of the report’s findings, a number of state restaurant associations and state and local chambers of commerce have come out in support of such laws. The report has also contributed to the adoption of voluntary smoke-free policies by employers and businesses, including major hotel chains.

Disparities in Secondhand Smoke Exposure

While secondhand smoke exposure among US nonsmokers has fallen substantially in recent years, many Americans continue to be exposed to this health hazard, and some groups are disproportionately impacted. For example, children are more heavily exposed to secondhand smoke than adults. Almost 60% of US children aged 3–11 years—or almost 22 million children—are exposed to secondhand smoke. About 25% of children in this age group live with at least one smoker, as compared to only about 7% of nonsmoking adults.

African Americans are also more heavily exposed to secondhand smoke on average than whites and Mexican Americans. Disparities in secondhand smoke exposure among ethnic and racial groups vary by setting. For example, some evidence suggests that Hispanics are less likely than other ethnic/racial groups to be covered by smoke-free workplace policies, but are more likely to have smoke-free home rules in place. Secondhand smoke exposure also tends to be higher for persons with lower incomes.


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