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Second-Hand Tobacco Smoke Exposure

Narrative

Exposure to secondhand tobacco smoke among nonsmokers can cause heart disease and lung cancer in adults, as well as sudden infant death syndrome, respiratory and ear infections, and asthma exacerbation among children.1 Nonsmoking adults and children may be exposed at home, worksites or daycare centers, and public places.

In 2005–2008, an estimated 50.3 million or 37.0 percent of nonsmoking adults were exposed to secondhand tobacco smoke exposure, determined by detection of a tobacco marker in a blood sample. Overall, secondhand smoke exposure was more common among men than women (41.6 versus 33.4 percent, respectively). However, this sex difference was not observed among adults living in households with incomes below the poverty level, where more than half of adults were exposed to secondhand smoke. Secondhand smoke exposure decreased as income increased, but more so for women than men. Since only 6.3 percent of nonsmoking adults reported living in a household with a smoker, the majority of secondhand smoke exposure occurs outside the home.

Exposure to secondhand smoke also varies by race and ethnicity. Over half of non-Hispanic Black women were exposed to secondhand smoke compared to about 30 percent of non-Hispanic White and Hispanic women. While this racial and ethnic disparity may partly reflect racial and ethnic differences in the metabolic clearance of the tobacco marker,2 nonsmoking Black women were also more likely than their non-Hispanic White counterparts to report living in a household with a smoker (10.2 versus 5.4 percent, respectively).

Although the prevalence of secondhand tobacco smoke exposure has declined by over 20 percent in the past decade, only half of all states and the District of Columbia have comprehensive smoke-free laws covering workplaces, restaurants, and bars.2 National Healthy People 2020 objectives include universal state adoption of comprehensive smoke-free laws and a 10 percent reduction in the proportion of nonsmoking persons exposed to secondhand smoke.3

1 U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. Atlanta GA: U.S. Department of Health and Human Services, CDC 2006.

2 Centers for Disease Control and Prevention (CDC). Vital signs: nonsmokers’ exposure to secondhand smoke — United States, 1999-2008. Morbidity and Mortality Weekly Report. September 2010;59(35):1141-6.

3 U.S. Department of Health and Human Services. Healthy People 2020: Topics and Objectives. Accessed 06/08/11.

Graphs

Data

Secondhand Smoke Exposure* Among Nonsmoking Adults Aged 18 and Older, by Poverty Status** and Sex, 2005–2008
Poverty Status Percent of Adults
Female Male
*Defined as a serum cotinine level ≥0.05ng/mL among nonsmokers who did not report current smoking and had a serum cotinine level ≤10ng/mL.
**Poverty level, defined by the U.S. Census Bureau, was $22,025 for a family of four in 2008.
Source: Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey, 2005-2008. Analysis conducted by the Maternal and Child Health Information Resource Center.
Less Than 100% of Poverty 33.4 41.6
100-199% of Poverty 54.7 57.1
200-299% of Poverty 40.4 45.1
300% or More of Poverty 33.4 43.9
Total 25.9 37.7

Secondhand Smoke Exposure* Among Nonsmoking Women, by Race/Ethnicity,** 2005–2008

Percent of Women:

  • Non-Hispanic White: 31.4
  • Non-Hispanic Black: 52.2
  • Mexican American: 28.2
  • Other Hispanic: 30.5

*Defined as a serum cotinine level ≥0.05ng/mL among non-smokers who did not report current smoking and had a serum cotinine level ≤10ng/mL.
**The samples of American Indian/Alaska Native, Asian, and Native Hawaiian/Pacific Islander, and persons of multiple race were too small to produce reliable results.

Source: Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey, 2005-2008. Analysis conducted by the Maternal and Child Health Information Resource Center.

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