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America's Children: Key National Indicators of Well-Being, 2013

Environmental Tobacco Smoke

Children who are exposed to environmental tobacco smoke, also known as secondhand smoke, have an increased probability of experiencing such adverse health effects as infections of the lower respiratory tract, bronchitis, pneumonia, middle ear disease, sudden infant death syndrome (SIDS), and respiratory symptoms.55 Secondhand smoke can also play a role in the development and exacerbation of asthma. The U.S. Surgeon General has determined that there is no risk-free level of exposure to secondhand smoke.55 Cotinine, a breakdown product of nicotine, is a marker for recent (previous 1–2 days) exposure to secondhand smoke in nonsmokers.

Indicator Phy2.A: Percentage of children ages 4–11 with specified blood cotinine levels, selected years 1988–2010
Percentage of children ages 4–11 with specified blood cotinine levels, selected years 1988–2010

NOTE: Cotinine levels are reported for nonsmoking children only. "Any detectable cotinine" indicates blood cotinine levels at or above 0.05 nanograms per milliliter (ng/mL), the detectable level of cotinine in the blood in 1988–1994. The average (geometric mean) blood cotinine level in children living in homes where someone smoked was 1.0 ng/mL in 1988–199456 and in 2003–2006.57

SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey.

Indicator Phy2.B: Percentage of children ages 0–6 living in homes where someone smoked regularly by poverty status, 1994, 2005, and 2010
Percentage of children ages 0–6 living in homes where someone smoked regularly by poverty status, 1994, 2005, and 2010

NOTE: A home where someone smoked regularly is defined as one in which smoking by a resident occurred 4 or more days per week.

SOURCE: National Center for Health Statistics, National Health Interview Survey.

 

  • The percentage of children ages 4–11 with detectable blood cotinine levels decreased from 88 percent in 1988–1994 to 42 percent in 2009–2010. In 2009–2010, about 9 percent had blood cotinine levels more than 1.0 nanograms per milliliter (ng/mL), down from 26 percent in 1988–1994.
  • In 2010, the percentage of children ages 0–6 living in homes where someone smoked regularly was 6 percent, compared with 27 percent in 1994.58 Children living below the poverty level and Black, non-Hispanic children were more likely than their peers to be living in homes where someone smoked regularly.

 

 

 

 

table icon PHY2.A HTML Table, PHY2.B HTML Table

55 U.S. Department of Health and Human Services. (2006). The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, GA: 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.

56 Mannino, D.M., Caraballo, R., Benowitz, N., and Repace, J. (2001). Predictors of cotinine levels in U.S. children: Data from the Third National Health and Nutrition Examination Survey. CHEST, 120, 718–724.

57 Marano, C., Schober, S.E., Brody, D.J., and Zhang, C. (2009). Secondhand tobacco smoke exposure among children and adolescents: United States, 2003–2006. Pediatrics, 124(5): 1299–1305.

58 Regular smoking is defined as smoking by a resident that occurs 4 or more days per week.