BACKGROUND: The surgeon general has concluded that there is no safe level of exposure to secondhand smoke (SHS). Exposure to SHS causes heart disease, lung cancer, stroke and sudden infant death syndrome. It is estimated that close to 50,000 deaths due to coronary heart disease, lung cancer and stroke can be attributed to SHS exposure annually in the U.S. Although SHS has declined over the past 10 years, disparities in SHS exist across age, race/ethnicity, and poverty status.
METHODS: 2014 Kansas Behavioral Risk Factor Surveillance System data were used to asses SHS disparities among Kansas adults 18 years and older. Rules about smoking at home and in vehicles and SHS exposure in the past week were assessed. SAS complex survey procedures were used to calculate the overall prevalence of SHS exposure and smoking rules and sub-population prevalence by annual household income, race/ethnicity, and home ownership. Logistic regression models were used to compare the prevalence odds of smoke-free rules and SHS exposure by these disparity characteristics while controlling for current smoking status, gender and age.
RESULTS: Overall, 13.0% of Kansas adults always or sometimes allow smoking in their home. Among those with a vehicle, 20.2% always or sometimes allow smoking in the vehicle. When exposure to SHS during the past week was assessed, it was seen that 7.0% of Kansas adults had been exposed to SHS inside their home and 13.0% percent were exposed while riding in a vehicle. Smokers have a higher prevalence of both allowing smoking and of being exposed to SHS. For example, 41% of current adult smokers in Kansas allow smoking inside their home versus 7% of non-smokers and 25.4% were exposed to SHS in their home in the past week versus 3% of non-smokers. Even after controlling for smoking status and selected demographic characteristics, the lack of smoke-free rules and SHS exposure, at home and in vehicles, was significantly higher among those with annual household incomes of less than $25,000 and those who rent their home. No significant differences were observed in smoke free rules or SHS exposure among race/ethnic groups, with the exception of a higher prevalence of allowing smoking in vehicles among adults who were multi-racial.
CONCLUSIONS: Given disparities in SHS exposure, population based efforts to reduce SHS exposure in Kansas may benefit from targeted education efforts to increase voluntary policies that restrict smoking.