4.5 Prevalence of exposure to secondhand smoke in the home

Last updated: July 2019
Suggested citation:Campbell, MA, Greenhalgh, EM, Ford, C, & Winstanley, MH. 4.5 Prevalence of exposure to secondhand smoke in the home. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2019. Available from https://www.tobaccoinaustralia.org.au/chapter-4-secondhand/4-5-prevalence-of-exposure-to-shs-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 an important source of exposure to secondhand smoke. 2

The National Drug Strategy Household Survey provides the most recent data published on population prevalence of exposure to secondhand smoke in Australia. Exposure to secondhand smoke in the home for non-smoking children, adolescents and adults 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 4.16), 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, 3

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 National Drug Strategy Household Surveys has found that only 2.8% of households with dependent children had at least one person who smoked inside the home in 2016, a significant decrease from 3.7% in 2013, and a substantial drop from 31.3% in 1995 (see Figure 4.5.1). 1  

Figure 4.5.1 
Exposure to environmental smoke in the home, households with children aged 14 and under, 1995 to 2016

Source: National Drug Strategy Household Survey chapter 3 tables, 2016 1

Other Australian surveys indicate that among households with regular smokers, households with older children are less likely to have indoor smoking bans than households with younger children. 2-4 The percentage of reported smokefree homes declines as the age category of the youngest child in the household increases. 2, 4 In households with smokers, those with one or more adult non-smokers are more likely to have a smokefree home. 2 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 home 5 (see Section 9.1.6.1). Among those children who have a parent who smokes, the degree of exposure increases with the number of smokers residing in the home and the heaviness of tobacco smoking among residents. 6 Children whose parents have negative attitudes towards secondhand smoke and its health effects are less likely to be exposed. 5

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 all non-smokers aged 14 or older (including ex-smokers and those who had never smoked), 2.9% reported daily exposure to secondhand smoke in their home in 2016, a decrease from 6.0% in 2007. 1

Although there was some variation by state, in 2016, fewer than 5% of non-smokers 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 non-smokers reported having smokefree homes; that is, they either lived with a smoker who smoked only outside, or did not have a regular smoker in the household.

Figure 4.5.2 
Proportion of non-smokers who report living in a household where: a smoker smokes inside the home; a smoker smokes outside the home; or there is no smoker in the household, 2016, by state/territory

 

 

Note: 95% confidence intervals can be viewed here
Source: Cancer Council Victoria analysis of National Drug Strategy Household Survey data 2016 7

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.

Figure 4.5.3
Proportion of non-smokers who report living in a household where a smoker smokes inside the home; a smoker smokes outside the home; or no smoker in the household, 2001–2016, by state/territory

 

 

Note: 95% confidence intervals can be viewed here
Source: Cancer Council Victoria analysis of National Drug Strategy Household Survey data from 2001 to 2016

Other state-based research has similarly shown declines in exposure to secondhand smoke in the home. In New South Wales in 2014 approximately 93% of people aged 16 years and over lived in smokefree homes, a substantial increase since 1997 (70%). Adults in the fifth or most disadvantaged quintile were less likely to live in a smokefree home (89%), compared with the overall adult population or more advantaged groups. There was no significant difference between rural and urban areas. 8 In South Australia in 2015, 9% of the population reported that they were exposed to passive smoke in their own home. 9  

Secondhand smoke exposure provides additional exposure to nicotine and toxins for smokers. People who smoke and experience secondhand smoke exposure at home have significantly higher cotinine levels when compared with people who smoke who report no exposure to secondhand smoke at home, and this is independent of smoking intensity and other factors. 10

4.5.3 Exposure in disadvantaged groups

Disadvantaged populations are more likely to be exposed to secondhand smoke than the general population and this contributes to the greater burden of ill-health. 11 Due to the disparities in smoking rates, people in lower socioeconomic groups are more likely to be exposed to secondhand smoke in the home. 4, 12, 13 Children in the most disadvantaged households are far more likely to live with at least one smoker, and among households with a smoker, disadvantaged households are more likely to allow smoking indoors—see Sections 9.1.6 and 9.2.5. Similarly, consistent with the higher prevalence of smoking, Aboriginal and Torres Strait Islander peoples are more likely to be exposed to secondhand smoke in the home 14 —see Section 8.7.4


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References

1. Australian Institute of Health and Welfare. National Drug Strategy Household Survey (NDSHS) 2016 key findings data tables. Canberra: AIHW, 2017. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/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: 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 (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.

4. 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.

5. 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

6. 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. Int J Environ Res Public Health, 2014; 11(12):12499-513. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25469922

7. Australian Institute for Health and Welfare, National Drug Strategy Household Survey, 2016 [computer file]. Canberra: Australian Data Archive, The Australian National University; 2017.

8. Centre for Epidemiology and Evidence. Healthstats NSW. Sydney: NSW Ministry of Health, Available from: www.healthstats.nsw.gov.au.

9. Dono J, Bowden, J & Miller C. Key smoking statistics for SA - 2015., Adelaide, Australia: South Australian Health and Medical Research Institute (SAHMRI), 2015. Available from: https://www.sahmriresearch.org/user_assets/9a6c6665cb920a9113532c0ebab54e22e66a4f83/key_smoking_statistics_for_sa_2015_-_april_2016.pdf.

10. Lindsay RP, Tsoh JY, Sung H-Y, and Max W. Secondhand smoke exposure and serum cotinine levels among current smokers in the USA. Tobacco Control, 2016; 25(2):224-31. Available from: http://tobaccocontrol.bmj.com/content/25/2/224.abstract

11. 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.

12. Centre for Epidemiology and Research. Healthstats NSW, 2015, NSW Ministry of Health: Sydney. Available from: www.healthstats.nsw.gov.au.

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, 2010, University of Queensland: Brisbane.

14. Australian Bureau of Statistics. 4714.0 - national Aboriginal and Torres Strait Islander social survey, 2014-15  Canberra: ABS, 2016. Available from: https://www.abs.gov.au/ausstats/abs@.nsf/mf/4714.0.