Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke—United States, 1999–2012

February 3, 2015 / Vol. 64 / Early Release



MMWR Introduction

Exposure to secondhand smoke (SHS) from burning tobacco products causes premature death and disease in nonsmoking adults and children. No risk-free level of exposure exists. SHS exposure causes more than 41,000 deaths among nonsmoking adults and 400 deaths in infants each year, and costs approximately $5.6 billion annually in lost productivity. While population exposure to SHS has declined over the past 2 decades, many nonsmokers remain exposed to SHS in workplaces, public places, homes, and vehicles. About 7 of every 10 black children were exposed to SHS during 2011–2012.

During 1999–2000 through 2011–2012, SHS exposure among U.S. nonsmokers aged ≥3 years declined overall and among all population groups. However, during 2011–2012, one-quarter of U.S. nonsmokers, or 58 million persons, were still exposed to SHS, including 40% of children aged 3–11 years (15 million children). Moreover, declines in exposure over time have been slower, and prevalence of exposure remains higher, among children, non-Hispanic blacks, persons living in poverty, and persons who live in rented housing.

The Surgeon General has concluded that eliminating smoking in indoor spaces fully protects nonsmokers from SHS exposure. Continued efforts to promote comprehensive statewide laws prohibiting smoking in workplaces and public places, voluntary smokefree home and vehicle rules, and smokefree policies in multiunit housing are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather.

MMWR Highlights

Declines in prevalence of SHS exposure among nonsmokers, 1999–2012

  • The prevalence among nonsmokers aged >3 years declined from 52.5% during 1999–2000 to 25.3% during 2011–2012.
  • By age group, declines in SHS exposure were the greatest among adults aged >20 years, (55.6% change), and lowest among children aged 3–11 years (37.4% change).
  • By race/ethnicity, declines in SHS exposure were lowest among non-Hispanic blacks (36.6%) compared with Mexican-Americans (46.0%) and non-Hispanic whites (56.2%).
  • Among those living below the poverty level, SHS exposure declined from 71.6% during 1999–2000 to 43.2% during 2011–2012.
  • Among those who live in rented housing, SHS exposure declined from 68.1% during 1999–2000 to 26.8% during 2011–2012.

Prevalence of SHS exposure among nonsmokers, 2011–2012

  • Prevalence of SHS exposure among nonsmokers was higher among children aged 3–11 years (40.6%) and adolescents aged 12-19 years (33.8%) than among adults aged ≥20 years (21.3%).
  • Prevalence of SHS exposure among non-Hispanic black children was 68.9%.
  • Prevalence of SHS exposure among non-smokers who lived below the poverty level was 43.2%.
  • Prevalence of SHS exposure among non-smokers who lived in rented housing was 36.8%.


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