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Passive Smoking: Beliefs, Attitudes, and Exposures -- United States, 1986

In December 1986, the 18th Surgeon General's report on smoking and health was released (1). This report, "The Health Consequences of Involuntary Smoking," described the health effects of exposure to environmental tobacco smoke (ETS). Its major conclusions were 1) that involuntary (or passive) smoking is a cause of disease, including lung cancer, in healthy nonsmokers, and 2) that children of parents who smoke have a higher frequency of respiratory infections, such as pneumonia and bronchitis, than do children of nonsmoking parents.

To evaluate beliefs, attitudes, and exposure related to involuntary smoking among U.S. residents, questions about ETS were included in the 1986 Adult Use of Tobacco Survey, which was conducted by the Office on Smoking and Health, Center for Health Promotion and Education, CDC. Data for this telephone survey were collected from a national probability sample of 13,031 adults (greater than or equal to17 years of age) representing the noninstitutionalized, civilian U.S. population (2). Respondents were asked if they thought ETS was harmful to health in general and to their own health specifically and if they were annoyed by exposure to ETS. In addition, working respondents (n=8,600) were asked about the extent of their exposure to ETS at work and about policies that restrict smoking at their worksites. Finally, respondents were asked whether they would choose smoking or nonsmoking sections in planes, restaurants, and other public places when a choice was available.

Eighty-eight percent of all respondents (93% of never smokers, 89% of former smokers) considered ETS to be generally harmful to health. In addition, 79% of current smokers felt that ETS was generally harmful; of these, 75% reported that ETS was "very harmful" or "somewhat harmful," as opposed to "slightly harmful" or "not harmful." Sixty-nine percent of all respondents (62% of former smokers, 74% of never smokers) considered ETS to be harmful to their own health.* Seventy-one percent of all respondents (43% of current smokers, 74% of former smokers, and 85% of never smokers) were annoyed by the cigarette smoke of others.

Among working respondents, 42% reported restrictions on smoking in their workplaces; 3% reported a total ban on smoking; and 55% reported no restrictions. Sixty-five percent of respondents who reported no restrictions against smoking in their worksites are at least somewhat exposed to ETS. Of these, 14% reported a "very smoky" worksite. Fifty-three percent of respondents who worked in environments with restrictive smoking policies reported exposure to ETS. Of these, 11% reported that their worksite is "very smoky." Even among the 2.5% of respondents reporting a total ban on smoking in the workplace, 21% still reported being at least somewhat exposed to ETS at work.

If given a choice, 61% of all respondents choose nonsmoking seating in airplanes, restaurants, and other public places. Most former smokers (69%) and never smokers (82%) choose nonsmoking sections, as do 14% of current smokers. Reported by: Office on Smoking and Health, Center for Health Promotion and Education, CDC. Editorial Note: These data indicate that a large percentage of smokers and nonsmokers regard ETS as a health hazard. In addition, a majority of nonsmokers and almost half of current smokers are annoyed by ETS. These results represent substantial changes in beliefs and attitudes since the 1970s. For example, a national opinion survey conducted by the Roper Organization in 1978 for the Tobacco Institute (3) showed that 58% of respondents (40% of smokers, 69% of nonsmokers) considered passive smoking hazardous. The Roper survey also found that 60% of nonsmokers and 5% of smokers were annoyed by being near a person who was smoking.

In 1986, 36% of a random sample of the members of the American Society for Personnel Administration (ASPA)** reported that their worksites had restrictive smoking policies (4). A similar percentage of respondents to the Adult Use of Tobacco Survey reported such policies. In a second survey of ASPA members in 1987, the percentage of members reporting a restrictive smoking policy had increased to 54% (4). Data from the Adult Use of Tobacco Survey suggest that these policies reduce, but do not eliminate, ETS exposure in the workplace. In fact, the 1986 Surgeon General's report concluded that simply separating smokers and nonsmokers within the same airspace is not sufficient to prevent exposure of nonsmokers to ETS (1).

These data also show that the majority of Americans would choose nonsmoking sections in airplanes, restaurants, and other public places, if given a choice. In 1986, the Committee on Airliner Cabin Air Quality, which was appointed by the National Academy of Sciences, recommended a ban on smoking on all commercial domestic flights for the following reasons: 1) to lessen irritation and discomfort among passengers and crew, 2) to reduce potential health hazards for the cabin crew, 3) to eliminate the possibility of fires caused by cigarettes, and 4) to bring the cabin air quality into line with established standards for other closed environments (5). On April 23, 1988, a new federal law that prohibits smoking on domestic flights of 2 hours or less takes effect. This legislation is part of an ongoing national effort to protect nonsmokers from exposure to ETS. Regulations issued by the General Services Administration (GSA) in December 1986 now prohibit smoking in GSA-controlled facilities except in designated smoking areas (6). The 1990 Health Objectives for the Nation, which were adopted by the Public Health Service, recommend that all 50 states have laws by 1990 that both prohibit smoking in enclosed public places and require separate smoking areas in the workplace and in dining establishments (7). References

  1. Office on Smoking and Health. The health consequences of involuntary smoking: a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, Centers for Disease Control, 1987:vii; DHHS publication no. (CDC) 87-8398.

  2. Waksberg J. Sampling methods for random digit dialing. J Am Stat Assoc 1978;73:40-6.

  3. Roper Organization. A study of public attitudes toward cigarette smoking and the tobacco industry in 1978. New York: Roper Organization, May 1978.

  4. Bureau of National Affairs. Where there's smoke: problems and policies concerning smoking in the workplace. A BNA special report, 2nd ed. Rockville, Maryland: Bureau of National Affairs, 1987.

  5. National Academy of Sciences, Committee on Airliner Cabin Air Quality, Board on Environmental Studies and Toxicology, Commission on Life Sciences, National Research Council. The airliner cabin environment: air quality and safety. Washington, DC: National Academy Press, 1986.

  6. General Services Administration. Smoking regulations. Federal Register 1986;51:44258. (41 CFR Part 101-20).

  7. Public Health Service. Promoting health/preventing disease: objectives for the nation. Washington, DC: US Department of Health and Human Services, Public Health Service, 1980. *Current smokers were not asked this question. **ASPA is a society of personnel executives representing manufacturing and nonmanufacturing firms and nonbusiness organizations such as hospitals, educational institutions, and government agencies.



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