Findings Physical Environment | 2025 Health Of Women And Children Report

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US Summary

2025 Health of Women and Children Report 2025 Health of Women and Children Report – Executive Brief 2025 Health of Women and Children Report – State Summaries 2025 Health of Women and Children Report – Concentrated Disadvantage County-Level Maps 2025 Health of Women and Children Report – Measures Table 2025 Health of Women and Children Report – Infographics 2025 Health of Women and Children Report – Report Data (All States)

Air and Water Quality

Household Smoke Among Children

The adverse impact of environmental tobacco smoke (secondhand smoke) on children’s health is widely documented and recognized
.57  Secondhand smoke exposure is associated with numerous health problems
 in children, including respiratory infections, more frequent and severe asthma attacks, slower lung development, sudden infant death syndrome (SIDS) and premature death and disease from exposure to cancer-causing
 chemicals.58,59 

Changes over time. Nationally, the percentage of children ages 0-17 living in households where someone used cigarettes, cigars or pipe tobacco decreased 19%, from 12.7% to 10.3% between 2021-2022 and 2023-2024. In 2023-2024, 7.2 million children lived in households where someone smoked, 1.7 million fewer than in 2021-2022. 

Between 2021-2022 and 2023-2024, household smoke decreased:

24% among Hispanic (10.4% to 7.9%), 22% among multiracial (14.8% to 11.6%) and 18% among white (13.7% to 11.2%) children.
23% among boys (13.0% to 10.0%) and 14% among girls (12.3% to 10.6%).
21% among children with a caregiver who graduated from college (6.7% to 5.3%), and 15% among both children with a caregiver who graduated from high school (21.6% to 18.4%) and those who had a caregiver with some post-high school education (18.6% to 15.8%).

Graphic representation of Changes in Household Smoke Among Children By Race/Ethnicity information contained on this page. Download the full report PDF from the report Overview page for details.

During this time, the prevalence significantly decreased: 38% in Texas (12.9% to 8.0%), 32% in North Dakota (17.1% to 11.6%), 28% in California (8.0% to 5.8%) and 25% in Tennessee (17.9% to 13.4%).

Differences. The prevalence of household smoke significantly varied by geography, caregiver educational attainment, race/ethnicity and special health care needs status in 2023-2024. The percentage was:

4.7 times higher in West Virginia (21.9%) than in Utah (4.7%).
3.5 times higher among children with a caregiver who graduated from high school (18.4%) compared with children with a caregiver who graduated from college (5.3%).
2.3 times higher among American Indian/Alaska Native (16.9%) compared with Asian (7.5%) children.
1.5 times higher among children with special health care needs (13.7%) than those without special health care needs (9.0%).

Note: The values for American Indian/Alaska Native (16.9%), Black (12.1%), multiracial (11.6%) and Hawaiian/Pacific Islander (11.2%) children may not differ significantly based on overlapping 95% confidence intervals. The same is true for Asian (7.5%), Hispanic (7.9%) and Hawaiian/Pacific Islander children.

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