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March 5, 2007: Reducing Exposure to Secondhand Smoke

Allan S. Noonan, M.D., M.P.H., Dean, School of Public Health, Morgan State University

Dr. Noonan focused his remarks on the significant disparities that continue to exist among specific groups and their involuntary exposure to secondhand smoke. Children and teens are one such group and their exposure occurs primarily in the home and in vehicles. Almost one in four children aged 3 to 11 years lives in a household with at least one smoker compared to only about 7 percent of nonsmoking adults. Dr. Noonan talked about the EPA's efforts to educate parents about the dangers of secondhand smoke exposure in the home and vehicles. Dr. Noonan acknowledged that more research is needed to establish the most effective interventions in this area and that such targeted, sustained research is urgently needed, with a special focus on evaluating ongoing initiatives to establish what works. What we do know, however, is that smoke-free workplace and public place laws do lead to increased adoption of smoke-free home rules because more smokers quit and/or better understand the negative consequences of secondhand smoke exposure.

A second disparity in secondhand smoke exposure relates to race. African-Americans—especially children— are disproportionately exposed primarily in the home. While there are a few innovative initiatives underway, more research is needed to identify effective approaches to reaching this population.

A third disparity in exposure relates to occupation with blue collar, service, and hospitality employees more likely to be exposed to secondhand smoke on the job. Restaurant, bar and casino workers are at special risk and in 1999 only 28% of restaurant waiters and 13% of bartenders were protected by workplace policies compared to about 76% of white collar workers. Unlike smoke-free homes where the evidence is lacking about effective interventions, we do know what works for these settings: comprehensive smoke-free work policies. Unfortunately, casinos and gaming venues are often exempted from these policies so much work needs to be done to address this gap. Correctional facilities, another setting where there is a high level of exposure to secondhand smoke, have been slow to adopt smoke-free policies. However, there seems to be a growing trend to change this, and in 2004 the Federal Bureau of Prisons instituted an almost complete smoke-free policy in federal prisons.

The final disparity addressed by Dr. Noonan is in exposure to secondhand smoke by people who are low-income and low socio-economic status. Clearly, 100% comprehensive smoke-free policies do much to address this disparity in the workplace but tailored educational initiatives are also required to help this population understand steps they can take to protect themselves. Because low income populations often view smoking as a way to relieve stress, and also because they do not feel empowered to ask for changes in their lives, they are disproportionately exposed to the harm caused by secondhand smoke.

In closing his remarks, Dr. Noonan emphasized the need to continue to disseminate information about the harmful effects of secondhand smoke exposure and the importance of staying vigilant until all Americans are equally protected from this health hazard.

Following his opening remarks, Dr. Noonan introduced the panelists.

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