Smoke-Free Homes Now the Overwhelming Norm, Even in Tobacco States, CDC Reports
September 5, 2014
Mary K. Caffrey
Growing up in a smoke-free home is now the overwhelming norm for most Americans, with the share of smoke-free homes nearly doubling in the 20 years that ended in 2011, the Centers for Disease Control and Prevention said today in a new study.

Overall, the prevalence of smoke-free home rules increased from 43 percent during 1992–1993 to 83 percent during 2010–2011, according to the study, which appears in today’s Mortality and Morbidity Weekly Report, published by CDC.

In the study, researchers Brian A. King, PhD, Roshni Patel, MPH, and Stephen Babb, PhD, examined responses from the most recent Tobacco Use Supplement to the Current Population Survey, administered by the U.S. Census Bureau. They found that the cultural norm of not allowing smoking inside the house has become so widespread that in 1992-93, having 69.4 percent of homes smoke-free was enough to rate Utah first in the country. By 2011, that same rate put Kentucky at the bottom among states.

Progress in changing cultural norms about the rights of non-smokers, especially children, to live in a smoke-free environment has been considered key in reducing both the death and financial toll of tobacco use.  CDC estimates that secondhand smoke causes 41,000 deaths among nonsmoking adults and an estimated $5.6 billion in lost productivity. Reducing tobacco use is key to trimming the nation’s healthcare tab, as cigarettes cause most cases of lung cancer and are implicated in a host of other cancers. Cigarette use contributes to rising rates of diabetes, causes COPD, and also contributes to rheumatoid arthritis.
Ensuring that children grow up in smoke-free environments is critical for their health in two ways: First, years of research, contained in reports from the US Surgeon General, have outlined the harmful effects of smoking on children. Second, growing up around smokers makes a child more likely to start smoking at an earlier age. Public health officials have long known that the younger a smoker is when he or she has the first cigarette, the harder it is for that person to quit.
This year marks the 50th anniversary of “Smoking and Health,” the report to the Surgeon General that declared that cigarette smoking caused lung cancer in men and launched the public health crusade against tobacco. As Evidence-Based Oncology, a publication of The American Journal of Managed Care, reported at the anniversary, it took 20 years after that report to build the groundswell for smoke-free environments, which were the legacy of former U.S. Surgeon General C. Everett Koop.
As seen in today’s study, progress toward smoke-free homes has occurred in every state, even those where growing tobacco has been an integral part of the economy. Kentucky’s smoke-free home rate increased from 25.6 percent to 69.4 percent, North Carolina’s rate rose from 34.1 percent to 79.4 percent, and Virginia’s rate went from 39 percent to 85.6 percent.
The authors discussed efforts to ban tobacco use from multi-unit housing, which has emerged as the next frontier in the nation’s efforts against smoking. An earlier report from CDC estimated that banning smoking from all public housing would save $521 million a year, including $341 million in healthcare expenditures, much of it from Medicare and Medicaid.
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MMWR: Prevalence of Smoke-Free Home Rules, United States, 1992-93 and 2010-2011

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The Health Consequences of Smoking: 50 Years of Progress