Last week I reviewed a study that suggested that exposure to smoking in movies increased the risk of becoming a habitual smoker. Although that study showed that movie smoking was the stronger predictor of habitual use, a close second was whether the child was exposed to second hand smoking (SHS) at home. This is consistent with previous research showing that exposure to SHS at home increases the risk of smoking in children and teenagers. Yet, there is little research on the factors that predict exposure of SHS at home, which could greatly contribute to prevention efforts.

In order to help fill this information gap, a team from NYU recently published a study in the journal of the American Academy of Pediatrics that explores the factors associated with greater exposure to SHS at home. The authors examined data from the Medical Expenditure Panel Survey, a large epidemiological dataset sponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. The sample included 46,982 children living in 23,338 households with 52,337 adults.

The authors examined the number of smoking adults in the household and the family characteristics associated with such exposure.

The Results:

1. 34% of all children live with at least one smoking adult.
2. Those living below the federal poverty level were 400% more likely to be living with a smoker than those living at 400% of the federal poverty level.
3. Kids living in ethnic minority families were 40-60% LESS likely to be living with a smoker than kids living in Caucasian families.
4. Kids living in the west coast were about 34% less likely to be living with a smoker when compared to other regions.
5. Living with more than 2 adults doubled the risk of living with a smoker
6. Adults living with children were more likely to smoke than adults living alone!!!

The authors concluded that poverty and living with more than 2 adults were the stronger risk factors for exposure to SHS at home. The authors stated:

In the past 20 years, public smoking bans have led to the protection of large numbers of adults from SHS exposure. Children, however, are exposed primarily in the home and so remain exposed to SHS at consistently high levels. The large number of children who live with smokers, along with the complexity of the homes in which these children live, reinforces the urgent need for strategies to help protect children from the harms of exposure to adult tobacco use.

King, K., Martynenko, M., Bergman, M., Liu, Y., Winickoff, J., & Weitzman, M. (2009). Family Composition and Children’s Exposure to Adult Smokers in Their Homes PEDIATRICS, 123 (4) DOI: 10.1542/

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