Household Smoke - Children in Vermont

Vermont

The adverse impact of environmental tobacco smoke (secondhand smoke) on children’s health is widely documented and recognized. While exposure to secondhand smoke is bad for everyone, it is especially harmful to infants and children, whose bodies are still growing and developing. Secondhand smoke exposure is associated with numerous health problems in children, including: 

• Sudden infant death syndrome (SIDS).
• Respiratory infections, like pneumonia and bronchitis.
• More frequent and severe asthma attacks.
• Slower lung development.
• Slower or delayed physical development.
• Premature death and disease from exposure to cancer-causing chemicals.

Among children, exposure to secondhand smoke is associated with an increase in emergency department visits and overnight hospital stays. Children with asthma who are exposed to secondhand smoke have more frequent and severe reactions that result in more emergency visits. The estimated economic burden of secondhand smoke among children ages 3-14, measured in emergency department-related costs, was $62.9 million in 2010.

According to America’s Health Rankings analysis, the percentage of children living in households where someone smokes is higher among:

• American Indian/Alaska Native, Black, multiracial and white children compared with Asian and Hispanic children.
• Children whose caregivers did not graduate from college compared with children who have a caregiver with a college degree. 
• Children with special health care needs compared with children without special health care needs.

Most secondhand smoke exposure among children happens at home; therefore, many intervention strategies focus on the home environment. Since 2017, the Department of Housing and Urban Development has banned smoking in all public housing. The potential savings have been estimated at $154 million annually. 

The Community Preventive Services Task Force recommends smoke-free policies to protect nonsmokers from involuntary exposure to secondhand smoke and reduce tobacco use among smokers. Further, smoke-free housing can promote healthier living environments. Encouraging property managers and landlords to enforce smoke-free policies in multiunit housing can help protect other residents, particularly vulnerable populations such as children, from exposure to secondhand smoke. The Centers for Disease Control and Prevention suggests that implementing smoke-free laws may stimulate voluntary adoption of smoke-free rules for homes and private vehicles. Therefore, such laws could help create healthier home environments for children.

Healthy People 2030 has multiple objectives related to tobacco use and secondhand smoke, including: 

• Increasing the proportion of smoke-free homes.
• Reducing the proportion of people who don’t smoke but are exposed to secondhand smoke.
• Increasing successful quit attempts in adults who smoke.

Kegler, Michelle C., Erin Lebow-Skelley, Jaimie Lea, Adrienne M. Lefevre, Pam Diggs, Sally Herndon, and Regine Haardörfer. “Developing Smoke-Free Policies in Public Housing: Perspectives From Early Adopters in 2 Southern States.” Preventing Chronic Disease 15 (June 21, 2018): 170427. https://doi.org/10.5888/pcd15.170427.

King, Brian A., Richard M. Peck, and Stephen D. Babb. “Cost Savings Associated with Prohibiting Smoking in U.S. Subsidized Housing.” American Journal of Preventive Medicine 44, no. 6 (June 2013): 631–34. https://doi.org/10.1016/j.amepre.2013.01.024.

Merianos, Ashley L., Roman A. Jandarov, and E. Melinda Mahabee-Gittens. “Secondhand Smoke Exposure and Pediatric Healthcare Visits and Hospitalizations.” American Journal of Preventive Medicine 53, no. 4 (October 2017): 441–48. https://doi.org/10.1016/j.amepre.2017.03.020.

Nadhiroh, Siti R., Kusharisupeni Djokosujono, and Diah Mulyawati Utari. “The Association between Secondhand Smoke Exposure and Growth Outcomes of Children: A Systematic Literature Review.” Tobacco Induced Diseases 18 (March 3, 2020). https://doi.org/10.18332/tid/117958.

Yao, Tingting, Hai-Yen Sung, Yingning Wang, James Lightwood, and Wendy Max. “Healthcare Costs of Secondhand Smoke Exposure at Home for U.S. Children.” American Journal of Preventive Medicine 56, no. 2 (February 2019): 281–87. https://doi.org/10.1016/j.amepre.2018.08.013.