While fewer Americans are exposed to secondhand smoke than a decade ago, the high rates of exposure among children, blacks and low-income groups highlight continuing disparities among certain groups for certain health risk factors.
“Tobacco is a preventable cause of death in this country and secondhand smoke continues to expose too many people,” CDC Director Dr. Thomas Frieden said during a call with reporters Tuesday. “The harms caused by secondhand smoke are completely preventable—we have made progress, but we have more to make.”
Exposure to secondhand smoke was cut by more than half from 1999, when 53% of Americans were reported to be exposed, to 25%, or 58 million, by 2012, according to a report published Tuesday by the Centers for Disease Control and Prevention.
But the report showed the rate of decline varied by group. High rates of secondhand smoke exposure were still found among non-Hispanic blacks, where the prevalence fell from 74% in 1999 to 47% in 2012. Exposure to secondhand smoke was also high among the low-income population, where 43% of people living below the federal poverty level had high exposure to secondhand smoke.
A high rate of exposure was found among children, where the rate was 41% among those between the ages of 3 and 11. Among young, non-Hispanic black children, the rate was even worse—68% of those ages 3 to 11 were reported to be exposed to secondhand smoke compared with 37% for non-Hispanic whites and 30% for Mexican-American children of the same age range.
The report attributed the overall drop in secondhand-smoke exposure to laws banning indoor smoking in public places; 28 states and the District of Columbia have such bans.
Home remained the primary source for exposure among children despite an increase in the number of households that have voluntarily implemented their own smoking bans, up from 43% in 1992 to 83% in 2011. In October, the Department of Housing and Urban Development released an action plan (PDF) to encourage home and property owners to adopt smoke-free policies that prohibit smoking in individual units and indoor common areas within residences.
Rates remained high among renters, where 36% were exposed in 2012 compared with 19% of home owners.
To help change that disparity, the CDC urged multiunit residences to impose smoking bans.
“About 80 million Americans live in multiunit housing, where secondhand smoke can seep into smoke-free units and shared areas from units where smoking occurs,” said Brian King, acting deputy director for research translation in the CDC's Office on Smoking and Health in a statement. “The potential of exposure in subsidized housing is especially concerning because many of the residents, including children, the elderly and people with disabilities, are particularly sensitive to the effects of secondhand smoke.”
The surgeon general has concluded that there is no safe level of exposure to secondhand smoke, which the CDC estimates causes more than 41,000 deaths among nonsmoking adults and 400 deaths in infants annually at a cost of $5.6 billion in lost productivity.
In a statement, American Cancer Society Cancer Action Network President Chris Hansen urged more states to pass smoke-free laws to help further cut the health risk to children.
“We will not make further progress in keeping kids from using tobacco and helping tobacco users quit without concerted efforts to protect the populations being disparately affected by both higher tobacco use rates and secondhand exposure levels,” Hansen said. “Lawmakers in these communities must take action to reduce public exposure to secondhand smoke by enacting policies that help people quit and strong smoke-free policies that protect nonsmokers.”
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