Smoking patterns of household members and visitors in homes with children in the United States

Background: Environmental tobacco smoke (ETS), also called passive smoking, has been shown to have adverse effects on the health of children. Objective: To determine the prevalence and pattern of ETS exposure in US homes with children younger than 18 years. Design: We analyzed data from the 1994 National Health Interview Survey and Year 2000 Objectives supplement. A multistage sample design was used to represent the civilian, noninstitutionalized population of the United States. Main Outcome Measures: Frequency of smoking by household residents and visitors in homes with children. Results: Thirty-five percent of children in the United States-21 million children-live in homes where residents or visitors smoke in the home on a regular basis (greater than or equal to I d/wk). From the household perspective, regular smoking by residents and visitors occurs in 36% of homes in which children reside. in 92% of homes with children where residents smoke at home, they do so every day of the week. Sixteen percent of nonsmoking respondents with children report that other residents or visitors smoke in the home. In 6% of the homes where no residents smoke, there is nevertheless regular smoking by visitors. In multivariate regression analysis, the prevalence of regular smoking in homes with children varies by age of youngest child, race/ethnicity, number of parents in the home, parental educational level, income, and region of the country. Conclusions: Many children live in homes with ETS. Most respondents who smoke report that smoking occurs in the home every day. Visitors are an additional source of ETS in homes, including some homes where residents do not smoke. Clinicians who take care of children can advise parents, whether or not they smoke, on how to limit their children's ETS exposure.