Brief Original ReportSmoke-free home and vehicle rules by tobacco use status among US adults
Introduction
Secondhand smoke (SHS) exposure causes disease and death among nonsmoking adults and children (USDHHS, 2006, USDHHS, 2012, USDHHS, 2014). The Surgeon General has concluded there is no risk-free level of SHS exposure, and that completely eliminating smoking in indoor settings is the only way to fully protect nonsmokers (USDHHS, 2006). In the past decade, considerable progress has occurred in the implementation of comprehensive state and local smoke-free laws that prohibit smoking in worksites, bars, and restaurants; as of January 2015, 26 states and the District of Columbia had implemented such laws (CDC, 2015).
Historically, the voluntary adoption of smoke-free policies has increased, however, homes and vehicles remain significant sources of SHS exposure, particularly for children (USDHHS, 2006). One international study from New Zealand demonstrated that youth SHS exposure rates in vehicles and homes decreased between 2006 and 2012 (Healey et al., 2015). A US study from 2009–2010 found the prevalence of SHS exposure in vehicles to be 73.6% (King et al., 2013) and another national study reported the prevalence of smoke-free home rules increased from 43.0% in 1992–1993 to 83.0% in 2010–2011 (CDC, 2014a).
Although cigarette smoking has declined (USDHHS, 2014), more Americans are using other tobacco products, including combustible (e.g., cigars, cigarillos, and little cigars), noncombustible (e.g., chewing tobacco and snus), and emerging products (e.g., electronic cigarettes) (USDHHS, 2014, CDC, 2014b). As highlighted in the 2014 Surgeon General's report, this diversification of the tobacco product landscape has made it increasingly important to assess tobacco control interventions in the context of all forms of tobacco use (USDHHS, 2014).
In addition to protecting nonsmokers from SHS (USDHHS, 2006, USDHHS, 2014), implementing smoke-free rules in private settings can encourage smoking cessation (USDHHS, 2012), prevent relapse, and reduce the social acceptability of tobacco use (Hopkins et al., 2010). To date, studies of smoke-free home and vehicle rules have been assessed by cigarette smoking; however, no studies have assessed such rules by other tobacco use (King et al., 2013). Therefore, we assessed the prevalence and characteristics of smoke-free home and vehicle rules among US adults by tobacco use.
Section snippets
Data source
Data came from the 2012–2013 National Adult Tobacco Survey (NATS), a landline and cellular telephone survey of noninstitutionalized civilian US adults aged ≥ 18 (CDC, 2013). The sampling design was composed of independent samples drawn from households in the 50 US states and District of Columbia. During October 2012 to July 2013, 60,192 interviews were completed (landline: 57,999; cellular: 2193); the response rate was 44.9% (landline: 47.2%; cellular: 36.3%).
Smoke-free rules
Smoke-free home rules were
Smoke-free home rules
Overall, 83.7% of adults had smoke-free home rules. By tobacco use, prevalence was highest among nonusers (90.8%), followed by noncombustible-only users (82.5%), both combustible and noncombustible users (54.9%), and combustible-only users (53.7%) (Table 1). Irrespective of tobacco use, prevalence was generally higher among males and respondents aged 44 years and less, married or partnered, with a graduate degree, income of ≥$100,000, or living in the West (Table 1).
Chi-square findings revealed
Discussion
This study reveals that approximately 8 in 10 US adults report smoke-free rules at home (83.7%) and in their vehicle (78.1%). However, variations in such rules exist by tobacco use; about one-half of any tobacco users reported having smoke-free rules, while about one-third reported smoke-free vehicle rules. These findings indicate that opportunities exist to educate all tobacco users about the dangers of SHS and to promote voluntary adoption of smoke-free rules in private settings, particularly
Conclusion
Most US adults have implemented smoke-free home and vehicle rules; however, variations exist by tobacco use status. Completely eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from SHS; separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot completely eliminate exposure (2). Continued efforts to educate all tobacco users about the importance of voluntary smoke-free rules in homes and vehicles are warranted as part of a
Conflict of interest statement
The authors declare that there are no conflicts of interests.
Author contributions
All authors contributed to the writing of this paper. JK drafted the manuscript. AJ analyzed the data. JK, DH, SB, BK designed the study and interpreted the data. All authors approved the final version to be submitted for consideration of publication.
Acknowledgments
The findings and conclusions in this report are those of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
References (18)
- et al.
Association between smokefree laws and voluntary smokefree-home rules
Am. J. Prev. Med.
(2011) - et al.
Smoke-free policies to reduce tobacco use: a systematic review
Am. J. Prev. Med.
(2010) - et al.
Exposure to secondhand smoke and voluntary adoption of smoke-free home and car rules among non-smoking South African adults
BMC Public Health
(2014) - et al.
Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption
Cochrane Libr.
(2010) Vital signs: current cigarette smoking among adults aged ≥ 18 years—United States, 2005–2010
MMWR Morb. Mortal. Wkly Rep.
(2011)Office on Smoking and Health and ICF. 2012–2013 National Adult Tobacco Survey Sample Design and Methodology Summary
(2013)Prevalence of smoke-free home rules—United States, 1992–1993 and 2010–2011
MMWR Morb. Mortal. Wkly Rep.
(2014)Tobacco product use among adults—United States, 2012–2013
MMWR Morb. Mortal. Wkly Rep.
(2014)State Tobacco Activities Tracking and Evaluation (STATE) System