4.14 Population prevalence of exposure to secondhand smoke in the home

Although most Australian non-smokers are not exposed to secondhand smoke in the home environment,1 for those individuals who do live with one or more smokers, the home can be a major source of exposure to secondhand smoke.2

The National Drug Strategy Household Survey 2007 provides the most recent data published on population prevalence of exposure to secondhand smoke in Australia. Exposure to secondhand smoke in the home has declined since 1995, reflecting a continuing decline in the prevalence of smoking as well as an increase in smokers who confine their smoking to outside the home environment (Table 4.14.1).3 Public awareness of health dangers of secondhand smoke has increased over time (see Section 4.16), and it is likely that increased regulation of smoking in the workplace and in public places over the past decade has also influenced attitudes to smoking in the home.2,4

Since 2007, implementation of smokefree legislation has continued. Some states have banned smoking in cars with children, and some local councils have implemented smokefree outdoor areas. Therefore the information in this section should be regarded cautiously, since it may provide higher estimates than reflect practice subsequent to 2007.

Levels of exposures to secondhand smoke in other settings, including the workplace and venues such as hotels, bars and restaurants and other indoor and outdoor areas, are discussed in Chapter 15.

Table 4.14.1
Household smoking status by dependent children status, Australia—1995 to 2007, % rounded

 


Dependent children*

No dependent children†

Household smoking status‡

1995

1998

2001

2004

2007

1995

1998

2001

2004

2007

Smokes inside the home

31

23

20

12

8

32

27

21

17

15

Only smokes outside the home

17

22

25

28

29

14

18

20

18

19

No-one at home regularly smokes

52

56

55

60

63

54

55

59

65

66

* Households containing dependent children aged 14 years or under

† Includes dependants aged 15 years and over

‡ Household smoking status as reported by respondents aged 14 years and over

Source: National Drug Strategy Household Surveys, as reported in Australia's health 20086

 

4.14.1 Exposure in infancy

A study undertaken during 1999 to 2002 in regional New South Wales, which assessed infants' exposure to secondhand smoke (verified by biochemical testing for cotinine in the infants' urine) found that more than one-quarter (27%) of babies aged up to 12 months had detectable amounts of cotinine in their urine.5 The number of smokers in the household had the greatest influence on infants' cotinine levels, followed by household smoking restrictions. In this study, 91% of infants lived in a home with a total smoking ban. Homes with non-smoking parents had the highest percentage of complete smoking bans (96%). Forty-one per cent of the infants lived in a household with one or more smokers. Among households with more than one smoker, 76% had a complete smoking ban, and in households where mothers smoked more than 10 cigarettes per day, only 46% had a complete smoking ban.5

4.14.2 Exposure in childhood

In 1995 almost one-third of households in which children lived included someone who smoked inside the home, declining to about 8% in 2007 (Table 4.14.1).6 Smokers living in households that included children were less likely to smoke indoors than smokers in households with no dependent children. Despite the significant reduction in exposure over the past decade, an estimated 300,000 dependent children aged 14 or under were still being exposed to secondhand smoke in the home in 2007.6

The prevalence of smoking indoors appears to have fallen more rapidly among households with dependent children than among households without—see Figure 4.14.1

 

Figure 4.14.1

Figure 4.14.1
Percentage of households where at least one person smokes indoors*, 1995 to 2007—households with† and without‡ dependent children, % rounded

* as reported by respondents aged 14 years and over

† Households containing dependent children aged 14 years or under

‡ Includes dependants aged 15 years and over

Source: National Drug Strategy Household Surveys, as reported in Australia's health 20086

4.14.3 Exposure in non-smoking teenagers and adults

The National Drug Strategy Household Survey (2007) reports that most Australian non-smokers are not exposed to secondhand smoke inside the home.1 Data analysed by age groups from the previous survey in 2004 showed that the vast majority of non-smoking adults aged 20 or older were not exposed to secondhand smoke in the home, with only 6% reporting that they lived in a house in which smoking occurred. However, compared to adults, teenagers (12 to 19 years) were more likely to live with one or more smokers, and were two to three times more likely to be exposed to smoke inside the home.4 Other Australian surveys indicate that among households with regular smokers, households with older children are less likely to have indoor smoking bans than household with younger children.2,7 The percentage of reported smokefree homes declined as the age category of the youngest child in the household increased.2,7 In households with smokers, those with one or more adult non-smokers had higher levels of smokefree homes.2

Apart from protecting the health of non-smoking adults and children, restrictions on smoking at home have also been shown to be associated with reduced smoking behaviour among adolescents and adults.811 See Chapter 5 for further discussion.

Evidence indicates that overall adult exposure to secondhand smoke has decreased dramatically over time. A British study examining long-term changes to exposure to secondhand smoke between 1978 and 2000 found that mean serum cotinine levels in non-smoking men dropped by about seven-fold from 1.36 ng/mL to 0.19 ng/mL. The percentage of men with low levels of cotinine (≤0.7 ng/mL) rose from 27% to 83% over the same time period.12

4.14.4 Levels of exposure to secondhand smoke in disadvantaged groups

As the relationship between socio-economic disadvantage and increased prevalence of smoking is well established—see Section 1.7 and Section 9.1—it is not surprising to find that members of disadvantaged groups are more likely to be exposed to secondhand smoke. Both the National Drug Strategy Household Survey (2007) and a 2008 Victorian population survey showed that, of households with at least one regular smoker, respondents who lived in low socio-economic status (SES) areas were more likely to report that the regular smoker smoked inside the home compared to respondents who lived in mid and high SES areas.7,13 The International Tobacco Control Four Country Survey, which includes respondents from Australia, Canada, the US and the UK, reported that low income was strongly linked to not having a smokefree home.2 However, this link was mediated by smoking-related variables such as high levels of addiction and a more pro-smoking environment (e.g. having more smoker friends). The authors noted that this result suggests that lower implementation levels of smokefree homes could be tackled through tobacco control policies.2 Data from the National Drug Strategy Household Survey series from 2001 to 2007 show a decrease in indoor smoking and an increase in outdoor smoking among smoking households across all SES groups. In the most disadvantaged SES group, changes from indoor smoking to outdoor smoking mainly occurred in households with children.13 The period covered by this data series coincides with the progressive introduction of smokefree public places and workplaces by the state and territory governments, as well as a number of other tobacco-control measures, including social marketing.

Disadvantaged children are particular risk. An analysis of National Drug Strategy Household Survey data from 2007 has shown that children of the most disadvantaged households are more than three times as likely to be exposed to secondhand smoke at home than children in the least disadvantaged circumstances (16% compared to 5%).13 A study from New South Wales (1998–99) found that children from families of lower SES, and children in single-parent families, are more likely to be exposed to secondhand smoke.14 Australian Bureau of Statistics data (2004–05) show that two-thirds of Aboriginal and Torres Strait Islander children aged under 15 years live in households with one or more regular smokers, and almost one-third (28%) live with at least one regular smoker who smokes indoors.15

The continued high exposure of some disadvantaged groups to secondhand smoke contributes to their greater burden of ill-health.16

Recent news and research

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References

1. Australian Institute of Health and Welfare. 2007 National Drug Strategy Household Survey: detailed findings. Drug statistics series no. 22, cat. no. PHE 107. Canberra: AIHW, 2008. Available from: http://www.aihw.gov.au/publications/phe/ndshs07-df/ndshs07-df.pdf

2. Borland R, Yong HH, Cummings KM, Hyland A, Anderson S and Fong GT. Determinants and consequences of smoke-free homes: findings from the International Tobacco Control (ITC) Four Country Survey. Tobacco Control 2006;15(suppl. 3):iii42–50. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16754946

3. Australian Institute of Health and Welfare. Australia's health 2010. Canberra: AIHW, 2010. Available from: http://www.aihw.gov.au/publications/index.cfm/title/11374

4. Australian Institute of Health and Welfare (AIHW). 2004 National Drug Strategy Household Survey: Detailed findings. AIHW cat. no. PHE 66. Drug Statistics Series No. 16. Canberra: Australian Institute of Health and Welfare, 2005. Available from: http://www.aihw.gov.au/publications/index.cfm/title/10190

5. Daly J, Wiggers J, Burrows S and Freund M. Household smoking behaviours and exposure to environmental tobacco smoke among infants: are current strategies effectively protecting our young? Australian and New Zealand Journal of Public Health 2010;34(3):269–73. Available from: http://www3.interscience.wiley.com/user/accessdenied?ID=123489784&Act=2138&Code=4719&Page=/cgi-bin/fulltext/123489784/HTMLSTART

6. Australian Institute of Health and Welfare. Australia's health 2008. AIHW Cat no. AUS 99. Canberra: AIHW, 2008. Available from: http://www.aihw.gov.au/publications/index.cfm/title/10585

7. Abbott J and McCarthy M. Smoking behaviour in homes and around children in Victoria: key findings from the 1998–2008 population surveys. Melbourne, Australia: Centre for Behavioural Research in Cancer, The Cancer Council Victoria, 2009. Available from: http://www.cancervic.org.au/downloads/cbrc_research_papers/09rps40_Smoking_Behaviour_in_homes_and_around_children_in_Victoria.pdf

8. Wakefield M, Banham D, Martin J, Ruffin R, McCaul K and Badcock N. Restrictions on smoking at home and urinary cotinine levels among children with asthma. American Journal of Preventive Medicine 2000;19(3):188–92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11020596

9. Farkas AJ, Gilpin EA, White MM and Pierce JP. Association between household and workplace smoking restrictions and adolescent smoking. Journal of the American Medical Association 2000;284(6):717–22. Available from: http://jama.ama-assn.org/cgi/content/abstract/284/6/717

10. Emory K, Saquib N, Gilpin EA and Pierce JP. The association between home smoking restrictions and youth smoking behaviour: a review. Tobacco Control 2010;19(6):495–506. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20852326

11. Mills AL, Messer K, Gilpin EA and Pierce JP. The effect of smoke-free homes on adult smoking behavior: a review. Nicotine & Tobacco Research 2009;11(10):1131–41. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19633273

12. Jefferis B, Thomson A, Lennon L, Feyerabend C, Doig M, McMeekin L, et al. Changes in environmental tobacco smoke (ETS) exposure over a 20-year period: cross-sectional and longitudinal analyses. Addiction 2009;104(3):496–503. Available from: http://eprints.ucl.ac.uk/13887/

13. Gartner C. 'Reported smoking inside and outside in households with and without dependent children, data from National Drug Strategy Household Survey 2001, 2004 and 2007', Unpublished data. Brisbane: University of Queensland. 2010.

14. Daly JB, Wiggers JH and Considine RJ. Infant exposure to environmental tobacco smoke: a prevalence study in Australia. Australia and New Zealand Journal of Public Health 2001;25(2):132–7. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11357908

15. Australian Bureau of Statistics. 4722.0.55.004 Tobacco smoking - Aboriginal and Torres Strait Islander people: A snapshot, 2004–05 Canberra: Australian Bureau of Statistics, 2007. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4722.0.55.004/

16. VicHealth Centre for Tobacco Control. Environmental tobacco smoke in Australia: what is being done and what could be done to reduce exposures. A report to Commonwealth Department of Health & Aged Care. Melbourne, Australia: VicHealth Centre for Tobacco Control, 2001.

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