Exposure to Secondhand Smoke Among Nonsmokers — United States, 1988–2014

Abstract

Exposure to secondhand smoke from burning tobacco products can cause sudden infant death syndrome, respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung cancer in adult nonsmokers (1). There is no risk-free level of secondhand smoke exposure (2). CDC analyzed questionnaire and laboratory data from the National Health and Nutrition Examination Survey (NHANES) to assess patterns of secondhand smoke exposure among U.S. nonsmokers. The prevalence of secondhand smoke exposure among U.S. nonsmokers declined substantially during 1988–2014, from 87.5% to 25.2%. However, no change in exposure occurred between 2011–2012 and 2013–2014, and an estimated one in four nonsmokers, or approximately 58 million persons, were still exposed to secondhand smoke during 2013–2014. Moreover, marked disparities persisted across population groups. Exposure prevalence was highest among nonsmokers aged 3–11 years (37.9%), non-Hispanic blacks (50.3%), and those who were living in poverty (47.9%), in rental housing (38.6%), or with someone who smoked inside the home (73.0%), or among persons who had less than a high school education (30.7%). Comprehensive smoke-free laws and policies for workplaces and public places and smoke-free rules for homes and vehicles can further reduce secondhand smoke exposure among all nonsmokers.

Comparison of Liquid Chromatography Mass Spectrometry and Enzyme-Linked Immunosorbent Assay Methods to Measure Salivary Cotinine Levels in Ill Children

“…Our secondary objectives were to determine how differences in cotinine values based on child demographics, TSE patterns, and housing types compared between the two methods. Overall, our results were consistent with prior research in that we observed higher cotinine levels using both methods in children who were: younger [35][36][37]; had lower household incomes [36,38,39]; and had higher numbers of cigarettes smoked by their primary caregiver or around them [24,39]. We did, however, observe differences in cotinine associations with sex and race/ethnicity that were only significant in models using LC-MS/MS-derived cotinine levels.…”

Annual report to the nation on the status of cancer, part II: Progress toward Healthy People 2020 objectives for 4 common cancers

“…Recent studies estimate that from 4400 to 7330 lung cancer deaths each year among never‐smokers in the United States can be attributed to secondhand smoke exposure . Our report shows that secondhand smoke exposure fell in the past decade, continuing declines beginning in the late 1980s, when almost 90% of the US population was exposed . Much of this decline can be attributed to decreases in smoking prevalence and to policies that prohibit smoking in indoor workplaces and public places, including restaurants and bars .…”

Current Prevalence of Major Cancer Risk Factors and Screening Test Use in the United States: Disparities by Education and Race/Ethnicity

“…Among nonsmokers, SHS exposure declined from 88% in 1988-1991 to 25% in 2013-2014 (unchanged from 2011-2012; ref. 44). However, people living below the poverty level (47.9%), blacks (50.3%), and people living in rental housing (38.6%) had considerably higher exposure (44).…”

“…44). However, people living below the poverty level (47.9%), blacks (50.3%), and people living in rental housing (38.6%) had considerably higher exposure (44). Almost 60% of the U.S. population is covered by comprehensive laws that prohibit smoking in all non-hospitality workplaces (such as offices, factories, and warehouses), restaurants, and bars; 25 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands have comprehensive, state-wide, smoke-free laws (45).…”