Household Smoke in New York

New York

The adverse impact of environmental tobacco smoke (more commonly known as secondhand smoke) on children’s health is widely documented and acknowledged. While exposure to secondhand smoke is bad for everyone, it is especially harmful for infants and children because their respiratory, immune and nervous systems are still developing. Furthermore, children are usually exposed to secondhand smoke involuntarily and do not have the means to avoid exposure.

Secondhand smoke exposure is associated with numerous health problems in children, including: 

• Weaker lungs.
• Respiratory illnesses such as pneumonia and bronchitis.
• More severe asthma attacks.
• Ear infections.
• Sudden infant death syndrome (SIDS).
• Behavioral problems and neurocognitive deficits.

Children who are exposed to secondhand smoke are more likely to have to use health care services such as visiting an emergency department or staying in a hospital overnight. The estimated economic burden of secondhand smoke among children ages 3-14 was $62.9 million for emergency room visits in 2010.

The percentage of children who live in households where someone smokes is higher among:

• American Indian/Alaska Native children compared with Hispanic children and non-Hispanic-white, Black and Asian children.
• Children living in lower income households compared with those living in higher income households. 

Children are exposed to most secondhand smoke in the home; therefore, many strategies to reduce secondhand smoke focus on the home environment. Reducing smoking among adults will decrease the number of children who are exposed to secondhand smoke.

Other key strategies for decreasing exposure to secondhand smoke include: 

• Promoting smoke-free public areas. Recent legislation has greatly decreased the amount of secondhand smoke that nonsmokers are exposed to and these broad policy interventions are tied to improvements in markers of population health.

• Promoting smoke-free housing. The U.S. Department of Housing and Urban Development banned smoking in all public housing in 2017, which could save $154 million annually according to a 2013 study. Prohibiting smoking in all government-subsidized housing would not only protect more nonsmokers from secondhand smoke exposure in their homes, but could also save an additional $360 million in annual smoking-related societal costs.

Healthy People 2030 has multiple objectives towards reducing the number of people who are exposed to secondhand smoke, including increasing the proportion of smoke-free homes and reducing the proportion of people who don’t smoke but are exposed to secondhand smoke.

DiFranza, Joseph R., C. Andrew Aligne, and Michael Weitzman. 2004. “Prenatal and Postnatal Environmental Tobacco Smoke Exposure and Children’s Health.” Pediatrics 113 (Supplement 3): 1007–15. https://doi.org/10.1542/peds.113.S3.1007.

Hahn, Ellen J. 2010. “Smokefree Legislation: A Review of Health and Economic Outcomes Research.” American Journal of Preventive Medicine 39 (6 Suppl 1): S66-76. https://doi.org/10.1016/j.amepre.2010.08.013.

King, Brian A., Richard M. Peck, and Stephen D. Babb. 2013. “Cost Savings Associated with Prohibiting Smoking in U.S. Subsidized Housing.” American Journal of Preventive Medicine 44 (6): 631–34. https://doi.org/10.1016/j.amepre.2013.01.024.

Merianos, Ashley L., Roman A. Jandarov, and E. Melinda Mahabee-Gittens. 2017. “Secondhand Smoke Exposure and Pediatric Healthcare Visits and Hospitalizations.” American Journal of Preventive Medicine 53 (4): 441–48. https://doi.org/10.1016/j.amepre.2017.03.020.

U.S. Department of Health and Human Services. 2007. “Children and Secondhand Smoke Exposure: Excerpts from The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.” Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. CDC:5173. https://stacks.cdc.gov/view/cdc/5173.

Yao, Tingting, Hai-Yen Sung, Yingning Wang, James Lightwood, and Wendy Max. 2019. “Healthcare Costs of Secondhand Smoke Exposure at Home for U.S. Children.” American Journal of Preventive Medicine 56 (2): 281–87. https://doi.org/10.1016/j.amepre.2018.08.013.