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Introduction
As of October 1, 2019, 36 states, along with the District of Columbia, and 5 U.S. territories have adopted comprehensive smokefree policies that include workplaces, restaurants, bars and state run-gambling establishments. There are an additional 1,085 cities and counties with laws that require non-hospitality workplaces, restaurants and bars to be smokefree.
E-cigarettes (also known as vapes or Electronic Nicotine Delivery Systems) are battery-powered devices that convert a liquid (“e-liquid”) into an aerosol. E-liquids typically contains nicotine, flavorings, vegetable glycerin, propylene glycol and other chemicals. Besides nicotine, e-cigarette aerosol may contain heavy metals, volatile organic compounds, and fine and ultrafine particles that can be inhaled deeply into the lungs by both users and by-standers. States and localities are increasingly incorporating prohibition of e-cigarette use into comprehensive smokefree air laws. As of January 2, 2020, 19 states, 929 municipalities, and three U.S. territories have prohibited the use of e-cigarettes in 100% smokefree locations.
Secondhand smoke (SHS) is a mixture of the side stream smoke released by a smoldering cigarette, pipe, hookah/waterpipe, or cigar, and the mainstream smoke exhaled by a smoker. SHS is a complex mixture containing thousands of chemicals, including formaldehyde, cyanide, carbon monoxide, ammonia, and nicotine. More than 250 of the chemicals in SHS are known to be harmful, and at least 69 are known to cause cancer.
Conclusive scientific evidence documents that 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. Today, comprehensive smokefree laws, covering public places and workplaces, including restaurants and bars are increasingly the norm. Additionally, smokefree policies may now extend to private spaces, including cars and multi-unit housing.
Measure
The percentage of indoor workers reporting a smokefree work environment.
The percentage of the population protected by local and state smokefree indoor air laws covering workplaces, restaurants, and bars. This measure draws on data collected and analyzed by the Americans for Nonsmokers’ Rights Foundation. Use of this information allows the National Cancer Institute (NCI) to include both local and state laws in its assessments.
Healthy People 2020 Target
- Increase the proportion of persons covered by indoor worksite policies that prohibit smoking to 100 percent.
- Increase the number of jurisdictions (states and Washington, D.C.) with smokefree indoor air laws that prohibit smoking in public places and worksites to 51.
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
National Cancer Institute. Tobacco Use Supplement to the Current Population Supplement for “work place smokefree policies” measures.
Americans for Nonsmokers Right Foundation. “Percentage of the population covered by local and/or state 100% smokefree air laws”.
Trends and Most Recent Estimates
Smokefree Workplace Rules
By Sex
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
---|---|---|---|
Percent of workers | 95% Confidence Interval | ||
![]() ![]() |
Both Sexes![]() |
80.2 | 79.7 - 80.6 |
Male![]() |
77.6 | 76.9 - 78.2 | |
Female![]() |
82.5 | 82.0 - 83.0 |
By Race/Ethnicity
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
---|---|---|---|
Percent of workers | 95% Confidence Interval | ||
![]() ![]() |
All Races![]() |
80.2 | 79.7 - 80.6 |
Non-Hispanic White![]() |
81.8 | 81.3 - 82.3 | |
Non-Hispanic Black![]() |
78.5 | 77.0 - 79.9 | |
Hispanic![]() |
74.1 | 72.4 - 75.7 |
By Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
---|---|---|---|
Percent of workers | 95% Confidence Interval | ||
![]() ![]() |
Ages 18-24![]() |
75.1 | 73.5 - 76.7 |
Ages 25+![]() |
80.9 | 80.4 - 81.3 |
By Sex and Age
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
---|---|---|---|
Percent of workers | 95% Confidence Interval | ||
![]() ![]() |
Males, ages 18-24![]() |
72.0 | 69.7 - 74.2 |
Males, ages 25+![]() |
78.3 | 77.7 - 79.0 | |
Females, ages 18-24![]() |
77.8 | 75.7 - 79.8 | |
Females, ages 25+![]() |
83.2 | 82.7 - 83.7 |
By Poverty Income Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
---|---|---|---|
Percent of workers | 95% Confidence Interval | ||
![]() ![]() |
< 200% of the federal poverty level![]() |
74.8 | 73.7 - 75.9 |
>= 200% of the federal poverty level![]() |
81.7 | 81.2 - 82.3 |
By Education Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
---|---|---|---|
Percent of workers | 95% Confidence Interval | ||
![]() ![]() |
Less than High School![]() |
69.1 | 66.9 - 71.3 |
High School![]() |
76.4 | 75.4 - 77.4 | |
Greater than High School![]() |
83.0 | 82.5 - 83.5 |
Indoor Air Laws
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
---|---|---|---|
Percent of population | 95% Confidence Interval | ||
![]() ![]() |
Workplaces![]() |
73.9 | Not available |
Restaurants![]() |
77.6 | Not available | |
Bars![]() |
66.2 | Not available |
Evidence-based Resources
The Cancer Control P.L.A.N.E.T. web portal contains tobacco control resources that support collaboration, identify evidence-based approaches, and list research-tested interventions. To identify high-risk populations and prioritize cancer control efforts, state and county-level tobacco data can be found on State Cancer Profiles.
Additional Information on Smokefree Workplace Rules and Laws
For the public
- Secondhand Smoke Exposure. National Cancer Institute.
- Health Risks of Secondhand Smoke. American Cancer Society.
- 50 Years of Progress: A Report of the Surgeon General, 2014. U.S. Department of Health and Human Services.
Scientific reports
- Changes in self-reported smokefree workplace policy coverage among employed adults-United States, 2003 and 2010-2011. Babb S, Liu B, Kenemer B Et al. Nicotine Tob Res 2017; 00(00): 1-9.
- 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.
- Association between smokefree laws and voluntary smokefree-home rules. Cheng KW, Glantz SA, Lightwood JM. Am J Prev Med 2011;41(6):566–72.
- Uneven Access to Smoke-Free Laws and Policies and Its Effect on Health Equity in the United States: 2000–2019. Hafez AY, Gonzalez M, Kulik MC, Vijayaraghavan M, Glantz SA. Am J Public Health. 2019;109(11):1568-1575.
- 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.
- Cancer Health Effects.. National Toxicology Program, U.S. Department of Health and Human Services.
- 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.
- National Health and Nutrition Examination Survey. Centers for Disease Control and Prevention, National Center for Health Statistics.
- State Tobacco Activities Tracking and Evaluation System. Centers for Disease Control and Prevention.