4.5 Prevalence of exposure to secondhand smoke in the home

The National Drug Strategy Household Survey provides the most recent data published on population prevalence of exposure to secondhand smoke in Australia.¹ Exposure to secondhand smoke in the home has been steadily decreasing.¹ This reflects a continuing decline in the prevalence of smoking as well as an increase in smokers who confine their smoking to outside the home environment. Public awareness of the health dangers of secondhand smoke has increased over time (see Section 4.19). Workers’ compensation claims (see Section 16.3) and litigation against the tobacco industry for misleading claims about the health effects of passive smoking (see Section 16.2.2) drove both increased public awareness and rapid adoption of policies and regulation of smoking in the workplace and in public places  from the late 1980 (See Chapter 15). These trends influenced attitudes to smoking in the home.²

Smoking bans in the home and car, factors that promote their implementation, and their positive effects on health and smoking behaviours, are discussed in detail in Section 15.6. 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.

4.5.1 Exposure in childhood

Data from the National Drug Strategy Household Survey indicates that the percentage of households with dependent children aged 14 years and under, who had at least one person smoking inside the home remained stable at 2.1% between 2019 and 2022–2023. This is a significant decrease from 2.8% in 2016 and 3.7% in 2013, and a substantial drop from 31.3% in 1995¹ (see Figure 4.5.1).

Of the 10.1 million Australian households that had children aged 14 years and under in 2022–2023, only about 200,000 reported anyone smoking inside the home.¹ Had rates of smoking indoors stayed at the levels they were prior to 1995 (31.3%), children in at least 2.96 million additional households would have been exposed to tobacco smoke in the home in 2022–2023.

Living in a smokefree household, however, is still not universal In Australia. Parental smoking, low socioeconomic status and lower level of education attained by parents are consistently identified to be associated with children’s secondhand smoke exposure in the home³ (see Section 9.1.6.1). Among children who have a parent who smokes, the degree of exposure increases with the number household residents who smoke and their heaviness of smoking.⁴ Children whose parents have negative attitudes towards secondhand smoke and its health effects are less likely to be exposed.³

4.5.2 Exposure in non-smoking teenagers and adults

Exposure to secondhand smoke in the home is also decreasing for Australian teenagers and adults. Among people aged 14 years and over who do not smoke (including people who formerly smoked and those who never smoked), 2.6% reported daily exposure to secondhand smoke in their home in 2022–2023. While this is similar to levels of exposure in 2019 (2.4%) this is a substantial decrease from 10.6% in 2001.⁵

Although there was some variation by state, in 2022–2023, 3% or less of people who do not smoke in each state and territory reported that a household member had smoked tobacco at least once per day in their home—see Figure 4.5.2. The remaining people who do not smoke reported having smokefree homes; that is, they either lived with someone who smoked only outside, or did not have someone who regularly smoked in the household.⁵

There has been a steady decline in the proportion of non-smokers who report exposure to tobacco smoke in the home in each state and territory since 2001—see Figure 4.5.3.

4.5.3 Exposure in disadvantaged groups

Disadvantaged populations are more likely to be exposed to secondhand smoke than the general population,^6-9 and this contributes to the greater burden of ill-health that such populations commonly experience. Due to the disparities in smoking rates, people in lower socioeconomic groups are more likely to be exposed to secondhand smoke in the home. Children in the most disadvantaged households are more likely to live with at least one person who smokes, and among households with a person who smokes, disadvantaged households are more likely to allow smoking indoors—see Sections 9.1.6 and 9.2.5 and Section 8.7.4.

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References

1. Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2022–2023 – 2. Tobacco smoking.  Canberra: AIHW. 2024. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey/data.

2. Borland R, Yong HH, Cummings KM, Hyland A, Anderson S, et al. Determinants and consequences of smoke-free homes: findings from the International Tobacco Control (ITC) Four Country Survey. Tobacco Control, 2006; 15(suppl. 3):iii42-iii50. Available from: https://pubmed.ncbi.nlm.nih.gov/16754946/

3. Orton S, Jones LL, Cooper S, Lewis S, and Coleman T. Predictors of Children's Secondhand Smoke Exposure at Home: A Systematic Review and Narrative Synthesis of the Evidence. PLoS One, 2014; 9(11):e112690. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25397875

4. Wang Y, Yang M, Tian L, Huang Z, Chen F, et al. Relationship between Caregivers' Smoking at Home and Urinary Levels of Cotinine in Children. International Journal of Environmental Research and Public Health, 2014; 11(12):12499-513. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25469922

5. Australian Institute of Health and Welfare. National Drug Strategy Household Survey, 2022-2023. ADA Dataverse. 2024. Available from: https://doi.org/10.26193/U6LY7H.

6. Shastri SS, Talluri R, and Shete S. Disparities in Secondhand Smoke Exposure in the United States: National Health and Nutrition Examination Survey 2011-2018. JAMA Intern Med, 2021; 181(1):134-7. Available from: https://doi.org/10.1001/jamainternmed.2020.3975

7. Australian Institute of Health and Welfare and National Indigenous Australians Agency. Measure 2.03 Environmental tobacco smoke, Aboriginal and Torres Strait Islander Health Performance Framework website.  Canberra: AIHW & NIAA. 2020. Available from: https://www.indigenoushpf.gov.au/measures/2-03-environmental-tobacco-smoke.

8. Nazar GP, Lee JT, Arora M, and Millett C. Socioeconomic Inequalities in Secondhand Smoke Exposure at Home and at Work in 15 Low- and Middle-Income Countries. Nicotine and Tobacco Research, 2016; 18(5):1230-9. Available from: https://pubmed.ncbi.nlm.nih.gov/26610936/

9. Talluri R, Shete SS, Shastri SS, and Shete S. Secondhand tobacco smoke exposure in homes and vehicles in youth: disparities among racial, and sexual and gender minorities. Frontiers in Public Health, 2024; 12:1370552. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39109147