1 in 4 Nonsmoking Americans is Still Exposed to Secondhand Smoke

After 2 ½ decades of progress, efforts to reduce exposure to secondhand smoke among non-smokers have stalled in the US, according to new data from the Centers for Disease Control and Prevention (CDC). An estimated 58 million Americans – including 14 million children ages 3 to 11 – were exposed to secondhand smoke from cigarettes and other tobacco-burning products during 2013-2014, the latest year for which there is data. The report was published December 6, 2018 in the CDC’s Morbidity and Mortality Weekly Report.

The CDC’s findings come from the National Health and Nutrition Examination Survey. It uses blood tests to measure exposure to secondhand smoke. The data show secondhand smoke exposure among US nonsmokers fell from 87.5% to 25.2% during 1988-2014. However, there was no change between the years 2011-2012 and 2013-2014. Exposure remains higher for certain groups, including children:

  • Higher among children ages 3-11 years (37.9%) than among those ages 12-19 years (32%) and adults (22%)
  • Higher among non-Hispanic black children (66.1%) than non-Hispanic white children (37.8%) and Mexican American children (22.2%)
  • Higher among people living below the poverty level (47.9%) than those living at or above the poverty level (21.2%)
  • Higher among those who rent their home (38.6%) than those who own their home (19.2%)
  • Higher among those with less than a high school education (30.7%) than those with a college degree (10.8%)

Dangers of secondhand smoke

Secondhand smoke contains the same harmful chemicals inhaled by smokers. It has more than 7,000 chemicals, including at least 70 that can cause cancer, including lung cancer – even in people who have never smoked. Like smoking, secondhand smoke exposure can also increase the risk of heart attack and stroke. In infants and children, secondhand smoke can cause sudden infant death syndrome, respiratory and ear infections, and asthma.

According to the 2014 Surgeon General’s Report, “The Health Consequences of Smoking – 50 Years of Progress,” exposure to secondhand smoke causes more than 41,000 deaths from lung cancer and heart disease among non-smoking adults and 400 deaths from sudden infant death syndrome every year.

Efforts to reduce exposure

Proven ways to reduce secondhand smoke exposure include comprehensive smoke-free laws in workplaces and public places, smoke-free home and vehicle rules, and educational messages warning about the risks of secondhand smoke.

Twenty-seven states and the District of Columbia have comprehensive smoke-free laws in all workplaces, restaurants, and bars at the state and local levels. But passing more laws like these has slowed in recent years. However, there has been progress at the local level since the data in this study were collected, which could be reflected in future surveys. During 2015–2017, 199 communities passed comprehensive smoke-free laws.

Some recent policies have also addressed smoking in private settings – the main sources of children’s exposure to secondhand smoke. For example, the US Department of Housing and Urban Development adopted a rule requiring public housing to be smoke-free by July 31, 2018.

Help quitting

If you smoke and you’re ready to quit or if you want to help someone else quit smoking, the American Cancer Society can help. Visit us online or call us at 1-800-227-2345 and we’ll help you get started.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Exposure to Secondhand Smoke Among Nonsmokers — United States, 1988–2014. Published December 6, 2018 in the CDC’s Morbidity and Mortality Weekly Report. First author James Tsai, MD, Centers for Disease Control and Prevention, Atlanta, Ga.


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