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Acting Surgeon General RADM Boris D. Lushniak on Zeroing Out Tobacco Use
A year after assuming the role of Acting Surgeon General and just before delivering a plenary address at the 2014 AMSUS meeting, RADM Lushniak...
Secondhand smoking (SHS) has declined dramatically—from 1 in 2 nonsmokers exposed to SHS between 1999 and 2000 to 1 in 4 between 2011 and 2012—thanks largely to changes in knowledge and habits. Since 2002, 26 states and the District of Columbia have implemented smoking bans for worksites, restaurants, and bars. And the proportion of smoke-free households in the U.S. nearly doubled, from 43% between 1992 and 1993 to 83% between 2010 and 2011, according to National Health and Nutrition Examination Survey data.
Related: Zeroing Out Tobacco Use
Nonetheless, 58 million people in the U.S. are exposed to SHS. Moreover, SHS kills > 400 infants and 41,000 adult nonsmokers every year, according to the CDC. The most vulnerable are children aged 3 to 11 years (2 in 5 are exposed to SHS), blacks (nearly half are exposed), people living below the poverty level, and home renters.
There is no risk-free level of SHS exposure, according to a study reported in the Morbidity and Mortality Weekly Report’s (MMWR’s) Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke—United States, 1999-2012. But eliminating smoking in indoor spaces fully protects nonsmokers from exposure to SHS. About half the U.S. population is covered by state or local smoke-free laws, but the home is still the prime source of smoking exposure, particularly in rental housing, multiunit housing, or public housing. The U.S. Department of Housing and Urban Development is encouraging smoke-free policies in subsidized and public housing and is creating smoke-free environments for employees, customers, and partners. As of October 2014, several hundred housing authorities had instituted such policies, including all 20 in Maine, according to the MMWR report.
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The CDC offers suggestions on how to cut down on SHS exposure. For health care professionals, these include asking patients about their smoking habits and encouraging them to quit if they smoke. Other suggestions include letting patients know that opening a window or using fans or air fresheners is not enough to make homes and cars smoke free, as well as emphasizing the importance of not allowing anyone to smoke around children, and especially with children, avoiding public places where smoking is allowed.