Disparities in Children's Exposure to Environmental Tobacco Smoke in the United States, 2007

Abstract

OBJECTIVES: This study examined racial/ethnic, socioeconomic, and geographic disparities in children's exposure to environmental tobacco smoke (ETS) or secondhand smoke in the home. METHODS: The 2007 National Survey of Children's Health (N = 90 853) was used to calculate the prevalence of children's exposure to ETS. State-level data on home smoking ban from the 2006–2007 Current Population Survey–Tobacco Use Supplement were used to supplement analyses. Logistic regression was used to estimate adjusted odds of exposure. RESULTS: In 2007, 7.6% of US children, or 5.5 million children, lived in households where someone smoked inside the home. The prevalence varied from a low of 1.1% for Utah and 1.9% for California to a high of 17.9% for West Virginia and 17.6% in Kentucky. After adjustment for sociodemographic factors, children in Ohio, West Virginia, Kentucky, and Pennsylvania had 12 times higher odds and those in Wisconsin, Missouri, Delaware, and the District of Columbia had 10 times higher odds of being exposed to ETS than children in Utah. Compared with children from higher socioeconomic backgrounds, Hispanic ethnicity, and non–English-speaking households, children from lower socioeconomic backgrounds had 7.3 to 10.6 times higher adjusted odds; non-Hispanic white, black, American Indian, and mixed-race children had 2.0 to 2.6 times higher odds; and children from English-speaking households had 4.1 times higher odds of ETS exposure. CONCLUSIONS: Considerable disparities exist in children's exposure to ETS, with geographic pattern strongly related to home smoking ban. Greater exposure to ETS among children in several states and disadvantaged socioeconomic groups is likely to exacerbate existing health disparities.