A Decline in Secondhand Smoke Exposure: Is This Enough?

A person’s decision to light up can have serious consequences for their health, but also for the health of those around them. Secondhand smoke is known to cause heart disease and lung cancer in nonsmoking adults but also to cause sudden infant death syndrome, acute respiratory infections, middle ear disease, exacerbated asthma, respiratory symptoms, and decreased lung function in children. Given these health hazards, how effective are our nation’s safeguards at preventing this secondhand exposure?

This week’s Morbidity and Mortality Weekly Report (MMWR), “Vital Signs: Nonsmokers’ Exposure to Secondhand Smoke – United States, 1999-2008,” provides the answer to this question by determining the proportion of the nonsmoking population who are exposed to secondhand smoke and by analyzing past trends in secondhand smoke exposure as determined by the 1999 to 2008 National Health and Nutrition Examination Surveys. Study results showed that the prevalence of secondhand smoke exposure among nonsmokers declined from 52.5% during the 1999-2000 survey to 40.1% during the 2007-2008 survey.

Despite this significant decrease in secondhand smoke exposure, this decline was only present for nonsmokers who did not live with a smoker in their home and also was not significant for non-Hispanic whites. This decline has also been shown to fluctuate from year to year and to be quite inconsistent. Furthermore, disparities among secondhand exposure still exists and study results have shown that exposure during every survey cycle is greater among men than among women; among non-Hispanic blacks than among non-Hispanic whites and Mexican-Americans; among children and youth than among adults; and among those below the federal poverty line than among those at or above the federal poverty line. What is most impressive, however, is that despite this decline in secondhand smoke exposure, 88 million nonsmokers who are above the age of three were still exposed to secondhand smoke during 2007-2008 and among these 88 million, 32 million were America’s children and youth (ages 3-19 years).

The results reported in this MMWR have major implications for public health practice and policies. Partnership for Prevention advocates for increases in state, local, and voluntary smoke-free policies in order to make this decline in secondhand exposure consistent and to eliminate existing disparities, especially among youth and children. Currently only twenty-four states and the District of Columbia have comprehensive smoke-free laws covering workplaces, restaurants, and bars. Complete state-wide bans are needed in order to reduce secondhand smoke exposure and protect the American public.

Homes were also shown to be a major source of secondhand smoke exposure, especially for children. Following the American Academy of Pediatrics and the U.S. Public Health Service’s recommendation, Partnership for Prevention supports efforts to increase clinician interventions for those parents who smoke. It is recommended that these parents not only get help in quitting smoking, but are also educated about the harms of secondhand smoke.

The Healthy People 2010 goal of reducing secondhand smoke exposure among the nonsmoking population to less than 56% has been accomplished. However, there are still a vast number of Americans who are exposed to the potential dangers of secondhand smoke. With more smoke-free policies and a greater emphasis on preventing at-home exposure, we can do a better job of safeguarding America’s nonsmokers.


Katie Burggraf
Tobacco Control Team
Partnership for Prevention