Preventing Exposure to Secondhand Smoke in the Community

Related Pages
  • Eliminating smoking is the only way to fully protect people who do not smoke from secondhand smoke (SHS) exposure.1
  • Comprehensive smokefree policies* prohibit smoking in all areas of indoor spaces, at all times. These policies can fully protect people from secondhand smoke exposure. Comprehensive smokefree laws are smokefree policies that prohibit smoking in all areas of workplaces and public places, including restaurants and bars.2,3,4
  • Comprehensive smokefree laws and policies can also help people who smoke quit and can help keep young people from starting to smoke.1,5
  • Many disparities in exposure, illnesses, deaths, and lost productivity could be prevented if comprehensive smokefree laws prohibiting smoking in all indoor areas of worksites, restaurants, and bars were implemented throughout the U.S.2,30,33
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* CDC defines a comprehensive smokefree law as one that prohibits smoking at all times, in all indoor areas of all workplaces, restaurants, and bars. If a law allows exemptions for designated or ventilated smoking areas in workplaces, restaurants, or bars, the state or community is not considered to have a comprehensive smokefree law. 

Benefits of comprehensive smokefree policies

  • Studies have found substantial declines in cotinine, a marker of secondhand smoke, among both hospitality workers and the public following the implementation of smokefree laws.6,7,8,9,10,11,12,13,14Cotinine is a byproduct the body creates when it breaks down nicotine, a major ingredient of tobacco smoke.
  • Research has found that smokefree policies lead to substantial declines in secondhand smoke exposure, with air quality improvements of up to 90% in high-risk settings, such as bars.15
  • Smokefree laws lead to reductions in coronary events (especially heart attacks), making comprehensive smokefree laws one of the most effective and cost-effective approaches for reducing heart disease—the leading cause of death—in the U.S.2
  • Comprehensive smokefree laws are associated with rapid reductions in hospitalizations related to heart attacks and strokes after the laws take effect.16,17
  • Smokefree laws in hospitality venues—such as restaurants, bars, and casinos—protect both employees and customers from the harmful health effects of secondhand smoke exposure. These policies are associated with improved indoor air quality and with reduced secondhand smoke exposure, reduced sensory and respiratory symptoms, and improved lung function in employees who do not smoke.2,18,19
  • Smokefree laws also can make it easier for people who smoke to quit, reducing their risk of disease.
  • Smokefree laws in workplaces and communities reduce tobacco use and increase smoking cessation.2,20,21
  • In 2010, a systematic review by the Task Force on Community Preventive Services reported that eleven studies found that smokefree laws and policies in workplaces were associated with a median 6.4% increase in tobacco use cessation, and twenty-one studies found that these laws and policies were associated with a median 3.4% decrease in tobacco use prevalence.5
  • Smokefree workplaces and communities make youth and young adults less likely to start smoking due to several factors, including seeing fewer role models smoke, fewer opportunities to smoke alone or with others, and reduced social acceptability for smoking.2
  • The implementation of smokefree laws increases the adoption of voluntary smokefree rules in homes.22 In turn, smokefree rules in homes may increase the adoption of smokefree rules for private vehicles.23 These rules can further protect people who do not smoke—especially those who are disproportionately affected by secondhand smoke exposure in homes and in vehicles, such as children.2,24

How smokefree policies vary across the U.S.

  • While exposure to secondhand smoke has declined in the U.S., not everyone is equally protected by comprehensive smokefree laws. As of July 1, 2022,
    • Only 62.5% of the US population is covered by 100% smokefree laws that apply to bars, restaurants, and worksites.25
    • Twenty-eight states, Puerto Rico, the U.S. Virgin Islands, and the District of Columbia have comprehensive smokefree laws in effect that prohibit smoking tobacco in private worksites, restaurants, and bars. Twenty-two states, Puerto Rico, and the U.S. Virgin Islands prohibit smoking in state-regulated gambling venues.25
    • Twenty-five states, Puerto Rico, and the District of Columbia prohibit the use of e-cigarettes in private worksites, restaurants, and bars, and 13 of those jurisdictions also prohibit the use of e-cigarettes in gambling venues.26
    • Over 1,100 U.S. cities and counties have comprehensive smokefree laws in effect that prohibit smoking tobacco products in private worksites, restaurants, and bars.25 There are also 1,006 local US communities that prohibit the use of e-cigarettes in 100% smokefree venues.26
  • Smokefree laws and policies have a high level of public support and compliance, and studies have shown they do not negatively affect sales of food and beverage items, or employment in the hospitality industry.27,28 Although the number of comprehensive smokefree laws has increased among states over time, variation and unequal protection remains. The tobacco industry has opposed these policies.29
  • Most comprehensive smokefree laws and policies also prohibit the use of e-cigarettes. The e-cigarette aerosol that people who use e-cigarettes breathe from the device and exhale can contain harmful and potentially harmful substances. Including e-cigarettes in smokefree or tobacco-free policies can protect people who do not use e-cigarettes from exposure to e-cigarette emissions, and can help change social norms about tobacco use. More information about e-cigarettes can be found on the Electronic Cigarettes page.

Why some population groups are more likely to be exposed to secondhand smoke

  • Uneven protections by smokefree laws and policies result in disparities in secondhand smoke exposure for some population groups.
    • Groups of people who are more likely than other groups to be exposed to secondhand smoke include: non-Hispanic, Black people; people who live below the federal poverty level; people with less than a college degree; people who live with someone who smokes inside the home; people who work in traditionally “blue collar” industries, service occupations, or construction; people who live in rental properties; and children 3-11 years of age.30
    • Almost two of every five children 3-11 years of age, including over half of non-Hispanic Black children, were exposed to secondhand smoke during 2017- 2018.30,31
    • During 2017-2018, secondhand smoke exposure among non-Hispanic Black individuals and those living below the poverty level continued to be approximately twice as high compared with non-Hispanic White individuals and those living above the poverty level, respectively.31,32

Many disparities in exposure, illnesses, deaths, and lost productivity could be prevented if comprehensive smokefree laws prohibiting smoking in all indoor areas of worksites, restaurants, and bars were implemented throughout the U.S.2,30,33

Smokefree policies in commercial and residential settings can minimize the effects of secondhand smoke

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