It is estimated that almost one in four children ages three to 11 years in the United States lives in a home with at least one smoker. Children who live with a smoker are likely to inhale secondhand smoke (also known as environmental tobacco smoke), which increases their risk of developing health problems like pneumonia, bronchitis, and other lung diseases, as well as increased asthma attacks and ear infections. The effects of secondhand smoke are particularly harmful for young children and children with asthma.
Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections among young children under 18 months of age each year. Mothers who smoke while pregnant are more likely than others to experience serious complications during their pregnancy. They are also more likely to give birth to infants who are of low birth weight (and are therefore more susceptible to serious health problems and mortality), and who are at an increased risk for Sudden Infant Death Syndrome (SIDS). Children born to mothers who smoked while pregnant, and possibly children whose grandmothers smoked while pregnant, have a higher risk of developing childhood asthma.,,
In addition to the increased health risks associated with smoking during pregnancy and second-hand smoke inhalation, children and adolescents who live in families with smokers are more likely to develop the habit themselves, further increasing their chances of developing serious health problems.
The proportion of single parents who report being current smokers declined overall between 1998 and 2012, from 36 to 27 percent, and was at 29 percent in 2013. In two-parent households, the proportion of parents who were current smokers declined between 1998 and 2007, from 23 to 17 percent. The proportion then remained steady until 2011, before continuing to fall to 15 percent in 2013. (Figure 1) Due to the sampling procedure used in the survey, data for the overall population of parents are not available.
Single parents are more likely to be smokers, even when accounting for gender differences in smoking prevalence. Among single parents in 2013, 29 percent were current smokers, compared with 15 percent of parents living in two-parent households. (Figure 1)Looking at fathers only, 31 percent of single fathers were smokers, compared with 17 percent of fathers in two-parent households. Single mothers were more than twice as likely as mothers in two-parent households to be current smokers: 29 and 12 percent, respectively. (Appendix 1)
The prevalence of smoking generally decreases with parents’ age. In 2013, parents in two-parent families who were between 18 and 24 were more than twice as likely as parents 35 and older to report being current smokers: 27, compared with 13 percent among parents ages 35 to 44 and 12 percent among parents ages 45 and older. Rates for parents 25 to 34 fell in the middle (13 percent). Among single parents, there were no significant differences by age. (Figure 2)
In 2013, Hispanic parents were the least likely to be smokers. Among single parents, white parents were the most likely to be current smokers (39 percent), followed by black parents (24 percent), and Hispanic parents (15 percent). Within two-parent families, whites and blacks were equally likely to report being current smokers (17 and 16 percent, respectively), with Hispanics the least likely to report being smokers, at nine percent. (Figure 3)
Parents with higher levels of education are significantly less likely than parents with less education to be current smokers. Among single parents in 2013, 15 percent with a bachelor’s degree reported smoking, compared with 29, 34, and 35 percent of parents with some college or an associate’s degree, a high school diploma, and less than a high school diploma, respectively. Within two-parent families, five percent of parents with a bachelor’s degree were current smokers, compared with 16 percent of parents with some college, and 25 and 22 percent of those with a high school diploma or without a high school diploma, respectively. There were no differences in smoking rates between parents without a high school diploma or equivalent, and those with only a high school diploma. (Figure 4)
Smoking is more common among parents living in households that receive TANF (welfare) or SNAP benefits (food stamps), or have incomes below the poverty line, than it is among parents living in other households. In 2013, 30 percent of parents in two-parent households living in families in which at least one person received income from TANF in the past year reported being a current smoker, compared with 14 percent of other parents in two-parent households. Similarly, those living in two-parent households in which someone was authorized to receive SNAP benefits were almost twice as likely as other single parents to report that they were current smokers in 2013 (30 versus 12 percent). Among parents in two-parent households with incomes that were at or above the poverty line, 13 percent reported being smokers, compared with 26 percent of single parents with incomes below the poverty line. (Figure 5) A similar pattern was evident among single parents, although there was no significant difference by household income. (Appendix 1)
Parents living in the West are less likely to smoke than parents in other parts of the country. In 2013, for example, 21 percent of single parents in the West reported being current smokers, compared with 31, 34, and 35 percent of single parents in the South, Northeast, and Midwest, respectively. Trends among parents in two-parent families are similar. (Appendix 1)
State-level estimates of youth and adult tobacco use from 1984 to 2013 can be obtained through the State Tobacco Activities Tracking and Evaluation (STATE) System of the Centers for Disease Control and Prevention. STATE is an online database containing information about tobacco use and prevention.
International estimates are available by region from the World Health Organization. Information is available for Africa, the Americas, Europe, South-East Asia, and Western Pacific, on topics including smoking prevalence, and related legislation, economics, and cessation.
Through its Healthy People 2020 initiative, the federal government has set many national goals concerning tobacco use. In addition to calling for decreased smoking among people of all ages, these goals include reducing the proportion of children and youth who are regularly exposed to secondhand smoke, and increasing the prevalence of tobacco-free environments in schools.
More information is available here.
See Child Trends’ LINKS database (“Lifecourse Interventions to Nurture Kids Successfully”), for reviews of many rigorously
evaluated programs, including the following which have been shown to be effective at reducing the risks to children from parental smoking:
“Current smokers” are defined as those who have ever smoked 100 cigarettes and currently smoke every day or some days. “Parents” are defined as parents of children under age 18 who live with at least one of their children.
Data for 1998-2013: Original analyses by Child Trends of the National Health Interview Survey.
National Health Interview Survey
|At or above poverty level||34.3||36.5||35.9||33.1||34.3||29.3||30.1||28.3||27.9||28.6||28.9||29.5||25.1||26.6||25.4||27.7|
|Below poverty level||39.6||42.0||41.1||37.2||40.8||39.9||39.8||39.1||36.5||34.7||42.0||37.6||32.3||39.7||30.6||34.4|
|Some high school or less||40.9||41.4||40.4||39.4||42.7||39.3||42.6||39.4||36.7||31.2||37.7||36.6||32.9||36.2||33.9||34.6|
|High school diploma/ GED or equivalent||42.1||44.5||46.2||38.7||42.9||36.9||37.3||37.0||35.5||38.6||43.3||40.3||36.9||36.1||31.4||34.2|
|Some college, no degree/AA degree||31.9||32.5||34.8||32.9||30.5||28.3||32.3||30.3||28.6||29.4||28.5||31.2||25.3||31.6||25.9||28.8|
|BA or higher||17.7||18.6||16.7||14.6||16.6||16.4||14.4||13.6||14.2||15.3||11.6||13.6||13.0||11.6||13.5||14.8|
|Received income from welfare/TANF||41.4||42.5||44.1||44.3||46.7||46.4||44.5||46.9||48.2||41.6||40.5||44.2||36.1||38.1||31.3||44.8|
|Did not receive income from welfare/TANF||34.1||35.6||36.4||32.5||34.3||30.1||31.8||30.2||28.6||29.1||31.1||31.3||26.9||29.4||26.4||28.6|
|Food Stamps/SNAP Receipt5|
|Authorized to receive food stamps/SNAP||40.9||42.3||45.3||42.7||44.0||42.3||43.4||41.9||39.4||37.1||47.0||44.5||37.1||39.3||33.0||38.6|
|Not authorized to receive food stamps/SNAP||33.3||34.9||34.9||31.1||32.6||28.3||29.2||27.8||26.3||27.4||24.7||26.0||21.7||23.3||21.9||22.8|
|Parents in two-parent households||23.2||21.8||22.5||21.0||20.9||20.5||18.5||19.2||18.7||16.8||18.8||18.0||16.4||17.3||16.6||14.8|
|At or above poverty level||22.7||21.7||22.1||20.8||20.5||19.7||18.1||19.0||18.0||16.0||17.9||16.9||15.0||15.7||15.3||12.7|
|Below poverty level||33.8||30.0||29.7||33.6||30.6||32.5||25.6||31.0||29.3||26.8||28.4||27.5||27.8||27.9||26.5||25.5|
|Some high school or less||34.5||30.8||32.1||29.4||31.4||31.2||26.5||27.5||25.0||25.1||27.2||26.0||24.0||26.1||22.3||21.6|
|High school diploma/ GED or equivalent||32.9||28.7||32.7||29.4||31.4||30.4||26.7||29.9||26.8||25.7||30.2||29.4||25.4||28.5||28.1||25.2|
|Some college, no degree/AA degree||22.8||22.0||21.1||22.4||20.9||19.0||19.7||19.0||21.1||17.9||20.3||18.5||19.1||18.7||17.7||16.2|
|BA or higher||8.6||10.5||8.6||8.0||6.5||7.5||6.3||31.0||6.7||5.1||6.4||6.3||5.6||5.8||6.0||4.9|
|Received income from welfare/TANF||43.2||36.1||41.5||39.2||37.7||43.9||38.9||28.7||40.3||39.5||37.6||40.2||23.9||37.8||34.2||29.5|
|Did not receive income from welfare/TANF||22.7||21.5||22.1||20.6||20.6||20.1||18.2||18.9||18.3||16.3||18.4||17.5||16.3||16.8||16.3||14.0|
|Food Stamps/SNAP Receipt5|
|Authorized to receive food stamps/SNAP||44.4||35.1||44.4||44.8||43.4||43.4||36.6||39.7||37.6||35.1||40.6||38.4||31.8||33.0||34.2||29.6|
|Not authorized to receive food stamps/SNAP||22.1||21.2||21.4||19.9||19.7||19.1||17.3||17.6||17.1||15.2||16.9||15.7||14.4||14.4||13.6||11.8|
|1Parents are defined as parents of children under age 18, residing with one or more of their children.2Current smokers are defined as those who have ever smoked 100 cigarettes and currently smoke every day or some days.
3 Because smoking data were obtained from a randomly chosen adult within a household, data for single parents and parents in two-parent households cannot be combined.
4 Persons of Hispanic origin may be of any race.
5 At least one family member receives benefit.
Source: Original analysis by Child Trends of National Health Interview Survey data 1998-2013.
Office of the U.S. Surgeon General. (2007). Secondhand smoke and children. Available online at http://www.surgeongeneral.gov/library/smokeexposure/report/fullreport.pdf
American Cancer Association. (2009). Secondhand smoke. Available online at http://www.cancer.org/docroot/PED/content/PED_10_2X_Secondhand_Smoke-Clean_Indoor_Air.asp
Andres, R. L., Day, M. C. (2000). Perinatal complications associated with maternal tobacco use. Seminars in Neonatology, 5(3), 231-241. DOI: 10.1053/siny.2000.0025
 Jakakkola, J. K. & Gissler, M. (2004). Maternal smoking in pregnancy, fetal development, and childhood asthma. American Journal of Public Health, 94(1), 136-140.
Lee, W. & Galant, S. (2002). Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children. Pediatrics, 110(2), 445-446.
LI, Y. F., Langholz, B., Salam, M. T., and Gilliland, F. T. (2005). Maternal and grandmaternal smoking patterns are associated with early childhood asthma. Chest, 127(4), 1232-41.
U.S. Department of Health and Human Services. (2000). Reducing tobacco use: A report of the Surgeon General–executive summary. Atlanta, Georgia: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Available online: http://www.cdc.gov/tobacco/data_statistics/sgr/2000/index.htm
Hispanics may be any race. Estimates for blacks and whites in this report do not include Hispanics.
Child Trends Databank. (2014). Parental smoking. Available at: https://www.childtrends.org/?indicators=parental-smokingLast updated: August 2014