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From 2013 to 2014, 38.0% of children aged 3-11 years were currently exposed to second-hand smoke.
Introduction
Conclusive scientific evidence documents that secondhand smoke (SHS) causes premature death and disease in children and adults who do not smoke. Exposure to SHS by adults has immediate adverse effects on the cardiovascular system, and long-term exposure to SHS causes coronary heart disease and lung cancer. Children exposed to SHS are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth.
There is no risk-free level of exposure to SHS, and only eliminating smoking in indoor spaces fully protects nonsmokers from exposure to SHS.
Exposure to secondhand smoke among non-tobacco users can be assessed by measurement of serum cotinine, a metabolite of nicotine. While serum cotinine levels may vary by individual due to the speed of nicotine metabolism and cotinine clearance, detection of serum cotinine above a minimum threshold is a validated measure of exposure to SHS in non-tobacco users.
Measure
The percentage of nonsmokers exposed to secondhand smoke. (The percentage of nonsmokers aged 3 years and older with a serum cotinine level greater than 0.05 ng/mL and less than or equal to 10 ng/mL.)
Healthy People 2020 Target
- Reduce the proportion of children aged 3 to 11 years who are regularly exposed to tobacco smoke to 47 percent.
- Reduce the proportion of adolescents aged 12 to 17 years who are regularly exposed to tobacco smoke to 41 percent.
- Reduce the proportion of adults exposed to secondhand smoke to 33.8 percent.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey. “Secondhand smoke exposure” measure.
Trends and Most Recent Estimates
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
Both Sexes
|
26.3 | 22.2 - 30.5 |
Male
|
27.9 | 23.9 - 31.9 | |
Female
|
25.0 | 20.2 - 29.8 | |
| ¹The 1988-1994 estimate starts at age 4 instead of age 3. | |||
| ²As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
All Races
|
26.3 | 22.2 - 30.5 |
Non-Hispanic White
|
23.9 | 18.0 - 29.8 | |
Non-Hispanic Black
|
49.6 | 44.9 - 54.2 | |
Hispanic
|
21.7 | 18.4 - 25.0 | |
| ¹The 1988-1994 estimate starts at age 4 instead of age 3. | |||
| ²As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
Ages 3-11
|
38.0 | 31.3 - 44.8 |
Ages 12-17
|
32.3 | 25.1 - 39.6 | |
Ages 18+
|
23.6 | 19.9 - 27.3 | |
| ¹The 1988-1994 estimate starts at age 4 instead of age 3. | |||
| ²As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
Males, Ages 3-11
|
39.3 | 32.3 - 46.3 |
Males, Ages 12-17
|
34.7 | 26.7 - 42.6 | |
Males, Ages 18+
|
25.1 | 21.1 - 29.1 | |
Females, Ages 3-11
|
36.7 | 28.6 - 44.8 | |
Females, Ages 12-17
|
29.8 | 21.3 - 38.4 | |
Females, Ages 18+
|
22.3 | 18.0 - 26.6 | |
| ¹The 1988-1994 estimate starts at age 4 instead of age 3. | |||
| ²As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
Adults by Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
Ages 18-29
|
35.2 | 28.5 - 41.9 |
Ages 30+
|
20.4 | 16.4 - 24.3 | |
| ¹As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
Adults by Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
Males, Ages 18-29
|
36.0 | 28.8 - 43.2 |
Males, Ages 30+
|
22.1 | 17.6 - 26.7 | |
Females, Ages 18-29
|
34.6 | 26.9 - 42.2 | |
Females, Ages 30+
|
19.0 | 14.6 - 23.3 | |
| ¹As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
37.9 | 33.0 - 42.8 |
>=200% of federal poverty level
|
19.2 | 15.5 - 22.8 | |
| ¹As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2013 to 2014) | |
|---|---|---|---|
| Percent of nonsmokers | 95% Confidence Interval | ||
|
Less than High School
|
31.6 | 25.6 - 37.5 |
High School
|
31.6 | 24.5 - 38.7 | |
Greater than High School
|
17.1 | 14.1 - 20.1 | |
| ¹As measured by a serum cotinine level of greater than 0.05 ng/ml and less than or equal to 10 ng/ml. | |||
Evidence-based Resources
State-level data are available on smoking that helps cancer control planner prioritize and develop plans to implement a cancer control program. Smokefree laws on each state are available, percentage of indoor workers reporting smoke-free policies at work regardless of state/local law policy (e.g., could be imposed by employer or building owner), and the percent of people not allowed to smoke in the home. Statistics are also available on the percent of state population with 100% smokefree in the workplace, restaurant, bar or all three.
Additional Information on Secondhand Smoke Exposure
For the public
- Second-Hand Smoke Exposure. National Cancer Institute.
- Secondhand Smoke and Cancer. National Cancer Institute.
- Health Risks of Secondhand Smoke. American Cancer Society.
- American Nonsmokers’ Rights Foundation.
- Overview List – How many smokefree laws? American Nonsmokers’ Rights Foundation.
- Summary of 100% Smokefree State Laws and Protected by 100% U.S. Smokefree Laws. American Nonsmokers’ Rights Foundation.
- U.S. 100% Smokefree Laws in Non-Hospitality Workplaces, Restaurants, and Bars. American Nonsmokers’ Rights Foundation.
- Ending the Tobacco Problem: Resources for Local Action. Institute of Medicine of the National Academies.
- 50 Years of Progress: A Report of the Surgeon General, 2014. U.S. Department of Health and Human Services.
Scientific reports
- Monograph 10: Health Effects of Exposure to Environmental Tobacco Smoke. National Cancer Institute.
- Tobaccos Use Supplement to the Current Population Survey. National Cancer Institute.
- Increasing prevalence of smoke-free homes and decreasing rates of sudden infant death syndrome in the United States: an ecological association study. Behm I, Kabir Z, Connolly GN, Alpert HR. Tob Control 2012;21(1):6–11.
- Smoking restrictions in bars and bartender smoking in the United States, 1992–2007. Bitler MP, Carpenter C, Zavodny M. Tob Control 2011;20(3):196–200.
- State and local comprehensive smoke-free laws for worksites, restaurants, and bars—United States, 2015. Centers for Disease Control and Prevention. MMWR 2016;65(24)623-626.
- Perspectives in Disease Prevention and Health Promotion 1986 Surgeon General’s Report: The Health Consequences of Involuntary Smoking. Centers for Disease Control and Prevention. MMWR 1986:35(50):769-70.
- Association between smokefree laws and voluntary smokefree-home rules. Cheng KW, Glantz SA, Lightwood JM. Am J Prev Med 2011;41(6):566–72.
- Occupation and workplace policies predict smoking behaviors: analysis of national data from the current population survey. Ham DC, Przybeck T, Strickland JR, et al. J Occup Environ Med 2011;53(11):1337–45.
- Parental home smoking policies: the protective effect of having a young child in the household. Hawkins SS and Berkman L. Prev Med 2011;53(1–2):61–3.
- Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke—United States, 1999-2012. Homa DM, Neff LJ, King BA, et al. MMWR 2015:64(4):103-108.
- National and state estimates of secondhand smoke infiltration among U.S. multiunit housing residents. King BA, Babb SD, Tynan MA, Gerzoff RB. Nicotine Tob Res 2013 Jul;15(7):1316-21.
- Home smoking bans among U.S. households with children and smokers. Opportunities for intervention. Mills AL, White MM, Pierce JP, Messer K. Am J Prev Med 2011;41(6):559–65.
- The role of worksite and home smoking bans in smoking cessation among U.S. employed adult female smokers. Rose A, Fagan P, Lawrence D, et al. Am J Health Promot 2011;26(1):26–36.
- The Health Consequences of Smoking—50 years of Progress: A Report of the Surgeon General, 2014. U.S. Department of Health and Human Services.
- Secondhand Smoke and What it Means to You. U.S. Department of Health and Human Services.
- About the Report on Carcinogens. National Toxicology Program, U.S. Department of Health and Human Services.
- The Health Consequences of Involuntary Exposure to Tobacco Smoke. U.S. Public.
- Battling tobacco use at home: an analysis of smoke-free home rules among U.S. veterans from 2001 to 2011. Zhang X, Martinez-Donate AP, Cook J, et al. Am J Public Health 2014 Sep;104 Suppl 4: S572-9.
Statistics
- Cancer Facts and Figures. American Cancer Society.
- State Tobacco Activities Tracking and Evaluation System. Centers for Disease Control and Prevention.