Tobacco Use

Secondhand Smoke Exposure

The percentage of individuals living in the US who are exposed to secondhand smoke has decreased over the last 60 years.1,2,3 Despite progress, disparities in secondhand smoke exposure persist. In 2022, over 1/3 of the US population lived in a community without comprehensive smoke-free laws that prohibit smoking in workplaces and public places.4 In addition, people who live in rental housing have a higher prevalence of secondhand smoke exposure (36.6%) than people who own their housing (18.6%).5 Indeed, recent estimates of secondhand smoke exposure show relatively high exposure to secondhand smoke among those individuals living in public housing, much of which is implicated in increased lung cancer, heart disease, and asthma morbidity/mortality6 (Figures 1.6.1 and 1.6.2). Even when nobody in the immediate household smokes, smoke exposure can drift from other units via hallways, stairwells, and ventilation systems, so much so that people who live in multi-unit housing have been found to have higher serum cotinine levels (i.e., a marker of nicotine exposure) than people who live in single-family homes.7,8,9,10

Among all age groups, children and the elderly may be especially vulnerable to secondhand smoke exposure. Children are vulnerable because of their increased time spent with caregivers and developmental status that enhance absorption of environmental toxicants.11 Among the elderly, individuals who live in public housing and have limited mobility may spend more time indoors, be exposed to more secondhand smoke exposure, and suffer more severe adverse health outcomes than the general population.12

Figure 1.6.1

Percentage of adults who never smoked and were residing in US public housing with exposure to secondhand smoke by health condition, 2011

Figure 1.6.2

Percentage of children with asthma who never smoked and were residing in US public housing with exposure to secondhand smoke, 2011

Up Next Smoking History and Lung Cancer Screening

Sources

  1. US Department of Health and Human Services. Smoking and Health Report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, DC: Public Health Service, 1964.
  2. US Department of Health and Human Services. The Health Consequences of Smoking-50 Years of Progress. A Report from the Surgeon General. Atlanta, GA; USA: Department of Health and Human Services. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2014.
  3. Patel AV, Deubler E, Teras LR, et al. Key risk factors for the relative and absolute 5-year risk of cancer to enhance cancer screening and prevention. Cancer. 2022.
  4. https://no-smoke.org/wp-content/uploads/pdf/mediaordlist.pdf
  5. US Department of Health and Human Services. Smoking and Health Report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, DC: Public Health Service, 1964.
  6. https://no-smoke.org/wp-content/uploads/pdf/mediaordlist.pdf
  7. Mason J, Wheeler W, Brown MJ. The economic burden of exposure to secondhand smoke for child and adult never smokers residing in U.S. public housing. Public Health Rep. 2015 May-Jun;130(3):230-44.
  8. Tsai J, Homa DM, Neff LJ, PhD, Sosnoff CS, et al. Trends in Secondhand Smoke Exposure, 2011-2018: Impact and Implications of Expanding Serum Cotinine Range. Am J Prev Med 2021;000(000):1−9.
  9. Licht AS, King BA, Travers MJ, Rivard C, Hyland AJ. Attitudes, Experiences, and Acceptance of Smoke-Free Policies Among US Multiunit Housing Residents. American Journal of Public Health 2012;102(10):1868-1871.
  10. Wilson KM, Klein JD, Blumkin AK, Gottlieb M, Winickoff JP. Tobacco Smoke Exposure in Children Who Live in Multiunit Housing. Pediatrics 2011;127(1):85-92.
  11. Farley SM, Jasek J, Debchoudhury I, Van Becka K, Talatia A, Perlman SF, et al. Housing type and secondhand smoke exposure among non-smoking New York City adults, 2004 and 2013-2014. Preventive Medicine Reports 2022; 27:101805.
  12. US Department of Health and Human Services. The Health Consequences of Smoking-50 Years of Progress. A Report from the Surgeon General. Atlanta, GA; USA: Department of Health and Human Services. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2014.