Exposure to Secondhand Smoke Among Nonsmokers, United States, 1988−2014

December 7, 2018 / Vol. 67 / No. 48



MMWR Introduction

Exposure to secondhand smoke from burning tobacco products can cause sudden infant death syndrome, respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung cancer in adult nonsmokers. There is no risk-free level of secondhand smoke exposure.

CDC analyzed questionnaire and laboratory data from the National Health and Nutrition Examination Survey (NHANES) to assess patterns of secondhand smoke exposure among U.S. nonsmokers.

Continued efforts to implement comprehensive smoke-free laws in workplaces and public places, adoption of smoke-free home and vehicle rules, and educational interventions warning about the risks of secondhand smoke exposure can further reduce secondhand smoke exposure, especially among vulnerable populations.

MMWR Highlights

Secondhand smoke exposure, overall

  • Secondhand smoke exposure among U.S. nonsmokers declined substantially during 1988–2014, from 87.5% to 25.2% (71.2% decrease).
  • No change in secondhand smoke exposure occurred between 2011–2012 and 2013–2014.
  • During 2013–2014, 58 million (1 in 4) U.S. nonsmokers were exposed to secondhand smoke.

Secondhand smoke exposure, by age groups, 1988–1991 to 2013–2014

  • Adult nonsmokers, aged ≥20 years: 87.4% to 22.0% (74.8% decrease).
  • Adolescents, aged 12-19 years: 87.4% to 32.0% (63.4% decrease).
  • Children, aged 3-11 years: 87.8% to 37.9% (56.8% decrease).

Secondhand smoke exposure among children aged 3-11 years, by race, 1988–1991 to 2013–2014

  • Mexican American children: 84.4% to 22.2% (73.7% decrease).
  • Non-Hispanic white children: 86.4% to 37.8% (56.3% decrease).
  • Non-Hispanic black children: 94.5% to 66.1% (30.1% decrease).

Disparities in secondhand smoke exposure, by demographic groups, 2013–2014

  • Higher among children aged 3-11 years (37.9%) than adults aged ≥20 years (22.0%).
  • Higher among non-Hispanic blacks (50.3%) than non-Hispanic whites (21.4%) and Mexican Americans (20.0%).
  • Higher among those who lived below the poverty level (47.9%) than those who lived at or above the poverty level (21.2%).
  • Higher among those who rented (38.6%) than those who owned their homes (19.2%).
  • Higher among those who lived with anyone who smoked inside the home (73.0%) than those who did not (22.3%).
  • Among adults aged ≥25 years, highest among those with less than a high school education (30.7%) and lowest among those with a college degree or higher (10.8%).


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