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 4.16). 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 National Drug Strategy Household Surveys indicates that only 2.1% of households with dependent children had at least one person who smoked inside the home in 2019, a significant decrease from 2.8% in 2016 and 3.7% in 2013, and a substantial drop from 31.3% in 1995 (see Figure 4.5.1).¹

Of the 9.7 million Australian households that had children aged 14 years and under in 2019, only about 200,000 reported anyone smoking inside the house. Had rates of smoking indoors stayed at the levels they were prior to 1995 (31.3%), children in at least 2.8 million additional households would have been exposed to tobacco smoke at home in 2019.

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 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.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 all non-smokers aged 14 or older (including ex-smokers and those who had never smoked), 2.4% reported daily exposure to secondhand smoke in their home in 2019, a statistically significant decrease from 2.9% in 2016 and a substantial decrease from 10.6% in 2001¹

Although there was some variation by state, in 2019, fewer than 3% 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.

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.

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%).⁶

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.⁷

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. Due to the disparities in smoking rates, people in lower socioeconomic groups are more likely to be exposed to secondhand smoke in the home.^8,9 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.and Section 8.7.4

Relevant news and research

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References

1. Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2019 - 2. Tobacco smoking chapter, supplementary data tables. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/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. 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. Int J Environ Res 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, 2019. ADA Dataverse, 2021. Available from: http://dx.doi.org/10.26193/WRHDUL.

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

7. 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

8. 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.

9. 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.