Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012
Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012
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发表时间：
2015-02
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通讯作者：
D. Homa;L. Neff;Brian A. King;R. Caraballo;R. Bunnell;Stephen D. Babb;Bridgette E. Garrett;C. Sosnoff-C
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作者：
D. Homa;L. Neff;Brian A. King;R. Caraballo;R. Bunnell;Stephen D. Babb;Bridgette E. Garrett;C. Sosnoff-C
背景：在不吸烟的儿童和成人中，接触烟草燃烧产生的二手烟会导致疾病和死亡。不存在无风险的SHS暴露水平。方法采用1999-2012年全国健康与营养调查（NHANES）数据，对3岁以上非吸烟人群的SHS暴露情况进行调查。非吸烟者的SHS暴露被定义为血清可替宁水平（尼古丁的代谢物）为0.05-10 ng/mL。根据年龄、性别、种族/民族、贫困程度、教育程度以及受访者是否拥有或租用住房，对SHS暴露进行了总体评估。结果非吸烟者SHS暴露率从1999-2000年的52.5%下降到2011-2012年的25.3%。在此期间，观察到所有人口亚组的人数都有所下降，但存在差异。2011-2012年期间，3-11岁儿童（40.6%）、非西班牙裔黑人（46.8%）、生活在贫困线以下的人（43.2%）和居住在租赁住房中的人（36.8%）是SHS最高的人群。在3-11岁的儿童中，67.9%的非西班牙裔黑人暴露于SHS，而非西班牙裔白人和墨西哥裔美国人的这一比例分别为37.2%和29.9%。总体而言，自1999-2000年以来，美国的SHS暴露量减少了一半。然而，在2011-2012年期间，仍有5800万人暴露于SHS，儿童、非西班牙裔黑人、贫困人口和租房者的暴露程度更高。消除室内吸烟可充分保护非吸烟者免受二手烟的危害；将吸烟者和非吸烟者分开，清洁空气和给建筑物通风并不能完全消除接触。继续努力促进全州范围内禁止在工作场所和公共场所吸烟的全面法律的实施，多单元住房的无烟政策，以及自愿的家庭和车辆无烟规则，对于保护不吸烟者在他们生活、工作和聚会的地方免受这种可预防的健康危害至关重要。
Background Exposure to secondhand smoke (SHS) from burning tobacco causes disease and death in nonsmoking children and adults. No risk-free level of SHS exposure exists. Methods National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 were used to examine SHS exposure among the nonsmoking population aged ≥3 years. SHS exposure among nonsmokers was defined as a serum cotinine level (a metabolite of nicotine) of 0.05–10 ng/mL. SHS exposure was assessed overall and by age, sex, race/ethnicity, poverty level, education, and whether the respondent owned or rented their housing. Results Prevalence of SHS exposure in nonsmokers declined from 52.5% during 1999–2000 to 25.3% during 2011–2012. During this period, declines were observed for all population subgroups, but disparities exist. During 2011–2012, SHS was highest among: children aged 3–11 years (40.6%), non-Hispanic blacks (46.8%), persons living below the poverty level (43.2%), and persons living in rental housing (36.8%). Among children aged 3–11 years, 67.9% of non-Hispanic blacks were exposed to SHS compared with 37.2% of non-Hispanic whites and 29.9% of Mexican Americans. Conclusion Overall, SHS exposure in the United States has been reduced by half since 1999–2000. However, 58 million persons were still exposed to SHS during 2011–2012, and exposure remains higher among children, non-Hispanic blacks, those living in poverty, and those who rent their housing. Implications for Public Health Practice Eliminating smoking in indoor spaces fully protects nonsmokers from SHS exposure; separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot completely eliminate exposure. Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather.