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Secondhand smoke harms people who never light up. In infants and children it can cause sudden infant death syndrome, respiratory and ear infections and asthma attacks; in adult nonsmokers, coronary heart disease, stroke and lung cancer. There is no risk-free level of exposure.
CDC measured exposure over a quarter-century using the National Health and Nutrition Examination Survey (NHANES), which tests blood for cotinine, a marker of recent nicotine exposure. A nonsmoker with serum cotinine of 0.05–10 ng/mL counted as exposed.
A dramatic decline
From 1988–1991 to 2013–2014, the share of U.S. nonsmokers exposed to secondhand smoke fell 71.2% — from 87.5% to 25.2%.
| Group | 1988–1991 | 2013–2014 | Decrease |
|---|---|---|---|
| Children 3–11 | 87.8% | 37.9% | 56.8% |
| Adolescents 12–19 | 87.4% | 32.0% | 63.4% |
| Adults 20+ | 87.4% | 22.0% | 74.8% |
Nonsmokers with evidence of secondhand smoke exposure, by age group, 1988–2014. Image from CDC’s report.
Among children 3–11, the decline was far smaller for Black children:
| Children 3–11 | 1988–1991 | 2013–2014 | Decrease |
|---|---|---|---|
| Non-Hispanic white | 86.4% | 37.8% | 56.3% |
| Non-Hispanic Black | 94.5% | 66.1% | 30.1% |
| Mexican American | 84.4% | 22.2% | 73.7% |
Children aged 3–11 with evidence of secondhand smoke exposure, by race and ethnicity. Image from CDC’s report.
But progress stalled
Between 2011–2012 and 2013–2014, there was no significant change. About one in four nonsmokers — approximately 58 million people, including 14 million children — were still exposed in 2013–2014.
Who is still exposed (2013–2014)
| Group | Exposed | Compared with |
|---|---|---|
| Children 3–11 | 37.9% | adults 22.0% |
| Non-Hispanic Black people | 50.3% | white 21.4%, Mexican American 20.0% |
| Living below the poverty level | 47.9% | at or above it, 21.2% |
| Less than high school education (25+) | 30.7% | college degree or more, 10.8% |
| Renters | 38.6% | homeowners, 19.2% |
| Living with someone who smokes indoors | 73.0% | those who don’t, 22.3% |
Why it fell — and why it stopped
The long decline probably reflects less smoking, greater awareness of secondhand smoke’s risks, and comprehensive smoke-free laws covering workplaces and public places in many states and localities. The stall during 2011–2014 may reflect a slowdown in new statewide laws. Progress has continued locally: 27 states and DC had comprehensive smoke-free laws; 199 localities adopted them during 2015–2017, and 21 more by July 2018. HUD required most public housing to be smoke-free by July 31, 2018, and Alaska passed a statewide workplace and public-place law in 2018, though localities can opt out.
Differences in smoking rates, policy coverage and awareness of the harms may explain the disparities.
What would help
- Comprehensive smoke-free laws for all workplaces and public places
- Smoke-free rules for homes and vehicles
- Education for parents and caregivers on the benefits of keeping homes and cars smoke-free
Limits: smoking status was self-reported; cotinine reflects only recent exposure; exposure below the standard cutoff was not counted; cotinine may also reflect exposure to other products, such as e-cigarettes, which was not assessed; and the survey design limited which racial and ethnic groups could be studied.
Sources
Based on Tsai J, Homa DM, Gentzke AS, et al., "Exposure to Secondhand Smoke Among Nonsmokers — United States, 1988–2014," MMWR Vol. 67, No. 48, CDC; a work of the United States government in the public domain. The report splits the 58.0 million exposed nonsmokers into 36.7 million adults, 9.1 million adolescents and 14.0 million children, which add to more than its total, so only the total and the children’s figure it repeats are given.
Licença: CC0 1.0 (domínio público) · Adaptado de www.cdc.gov
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