Smoke-Free Homes More the Rule than Exception

ATLANTA, May 29 -- The number of U.S. households with smoke-free homes in the U.S. increased significantly to 72.2% in 2003 from 43.2% in 1992, according to the CDC.

During that decade, the percentage of households claiming to allow no smoking anywhere inside the home increased in every state, researchers reported in the May 25 issue of the CDC's Morbidity and Mortality Weekly Report. The overall increase was 67%.

Some states have notable increases in smoke-free rules in the home. For example, during the 1992-1993 period, the percentage of no-smoking households was 25.7% in Kentucky. Ten years later, the percentage was 53.4%

The national prevalence of homes with no-smoking rules increased from 9.6% to 31.8% among households with at least one smoker and from 56.8% to 83.5% among households with no smoker. Regression analysis found no difference for these two types of homes.

The home is the primary source of secondhand smoke, exposure for infants and children and a major source of exposure for nonsmoking adults, the CDC researchers wrote.

The state with the smallest increase during this period was Utah, which in 1992-1993 already had the highest prevalence of homes with rules against smoking.

Other examples include California, going from 59.1% in 1992-1993 to 84.4% in 2003 (42.9% change); West Virginia, going from 27.8% to 57.1% (105.5% change); and New York, going from 41.6% to 70.5% (69.5% change).

Examples of other states with large increases in smoke-free homes included a group with low original scores, such as Alabama, Arkansas, Missouri, New Hampshire, North Carolina, South Dakota, and Tennessee.

States with the highest percentages of smoke-free homes included, Utah (88%), California (84%), Arizona (82%), and Oregon (81%).

A recent Surgeon General's report states that complete elimination of smoking in indoor spaces is the only measure that fully protects nonsmokers from second-hand smoke exposure. Other approaches, such as separation of smokers from nonsmokers and ventilation, are not effective. The evidence also suggests that smoke-free home rules help smokers quit and discourage young people from smoking.

The increase in smoke-free homes described in MMWR report might have been driven by two factors: an underlying decrease in smoking rates among adults and youths, and changes in knowledge and attitudes regarding the adverse health effects of second hand smoke, the researchers wrote. The large increase in smoke-free home rules that has occurred in households with smokers during the past 10 years suggests a considerable shift in social norms.

The findings in this report are subject to certain limitations. For example, estimates for homes with smoke-free rules were based on self-report and not validated by an objective measure. Also, a small number of households were excluded if members differed about the smoking rules in their homes.

The single best step that smokers can take to protect both the health of family members and their own health is to quit smoking. In addition to advising patients to quit smoking, healthcare providers can discuss the health effects of secondhand smoke exposure and recommend that they adopt smoke-free rules, the researchers wrote.

Although secondhand smoke exposure has decreased substantially among U.S. nonsmokers during the past 10 years, the findings of this report indicate that millions of children and nonsmoking adults remain at risk because their homes are not smoke-free.

Continued increases in the number of smoke-free workplaces, smoke-free public places, and smoke-free homes are needed to protect nonsmokers from this widespread and preventable health scourge, they concluded.