Number of smoke-free homes has doubled in 20 years

Although people are increasingly protected from the effects of secondhand smoke by laws that prohibit tobacco smoking in restaurants, bars, workplaces and other indoor public places, millions of nonsmokers - particularly children - are exposed to secondhand smoke in homes.

Approximately 41,000 nonsmoking Americans die each year from exposure to secondhand smoke. The cost to the economy in lost productivity caused by these premature deaths is estimated by the US Department of Health and Human Services to be $5.6 billion.

In the new report, the Centers for Disease Control and Prevention (CDC) analyze the most recent data from the Tobacco Use Supplement to the Current Population Survey, which is a long-running household survey distributed to the civilian population by the US Census Bureau.

The CDC compared the most recent data from 2010-11 with data from the first Current Population Survey in 1992-93.

New survey measures increase in homes with smoke-free rules

Each household member aged 18 years or older in the survey was asked the question: "Which statement best describes the rules about smoking inside your home?"

The answer options were:

  • "No one is allowed to smoke anywhere inside your home"
  • "Smoking is allowed in some places or at some times inside your home"
  • "Smoking is permitted anywhere inside your home."

If multiple members of the same household reported different answers - for example, if one said they had a smoke-free home, but another said that smoking is permitted - then they were excluded from the analysis.

The results show that the national prevalence of smoke-free homes increased from 43% in the 1992-93 survey to 83% during 2010-11.

The state with the highest number of smoke-free homes was Utah, with 93.6% of respondents in 2010-11 reporting that smoking was not allowed in their household. In 1992-93, 69.4% of households in Utah were smoke-free.

The state with the lowest prevalence of smoke-free homes in 2010-11 was Kentucky, with 69.4%. In 1992-93, Kentucky reported that only 25.6% of households were smoke-free.

Among households that reported having at least one adult smoker, there was an increase in national prevalence of no-smoking rules from just 9.6% in 1992-93 to 46.1% in 2010-11.

Why are more homes smoke-free?

In their report, the authors hypothesize that the increased prevalence of smoke-free home rules may be because of the state and local laws prohibiting smoking in public places and places of work, and also because there has been a decline in smoking overall.

But because there has been a large increase in the number of homes with no-smoking rules that have at least one adult smoker, the authors say that this could indicate a change in attitudes about the acceptability of smoking around nonsmokers.

However, because the data in the study was self-reported rather than validated by an objective measure, it is difficult to verify how accurate the findings are. Also, the survey only looked at cigarette smokers, so did not capture data on households where other tobacco products - such as cigars - may have been smoked.

Although substantial progress has been made in increasing the number of smoke-free homes, the authors note that fewer than half of all households with smokers have adopted these rules.

They conclude:

"This is concerning because nearly all nonsmokers who live with someone who smokes inside the home are exposed to secondhand smoke (SHS). Because 100% smoke-free indoor environments are the only effective way to fully eliminate SHS exposure, efforts are warranted to educate the public about the dangers of SHS and to promote the adoption of smoke-free home rules, particularly among subpopulations at greatest risk for exposure, such as those living in households with smokers, in states with lower prevalence of smoke-free home rules, and in multiunit housing."