Environmental tobacco smoke exposure in the home and worksite and health effects in adults: results from the 1991 National Health Interview Survey.

OBJECTIVE

To determine the effect of environmental tobacco smoke (ETS) exposure in the home and worksite on the health of adults in the United States.

DESIGN

Cross-sectional survey.

SETTING

Nationally representative population.

PARTICIPANTS

43,732 adults who completed the Health Promotion and Disease Prevention supplement in the 1991 National Health Interview Survey.

MAIN OUTCOME MEASURES

Rate of restricted activity, bed confinement, and work absence in the two weeks preceding the survey and self-reported health status among adults with and without exposure to ETS.

RESULTS

We found that only 20.2% of never-smokers and 23.1% of former smokers reported exposure to ETS at home or work, whereas 87.2% of current smokers reported exposure to ETS. Among never-smokers, after adjusting for covariates, people who were exposed to ETS were more likely to report one or more days of restricted activity (relative risk (RR) = 1.27, 95% confidence interval (CI) = 1.10 to 1.46), one or more days of bed confinement (RR = 1.43, 95% CI = 1.19 to 1.73), and one or more days of work absence (RR = 1.33, 95% CI = 1.05 to 1.73) in the two weeks before the survey than were people without such exposure. We detected smaller trends for one or more days of restricted activity among current and former smokers (RR = 1.16, 95% CI = 0.97 to 1.40; and RR = 1.11, 95% CI = 0.82 to 1.51), one or more days of bed confinement among current smokers (RR = 1.34, 95% CI = 0.95 to 1.88), and one or more days of work absence among former smokers (RR = 1.13, 95% CI = 0.84 to 1.50) in the two weeks before the survey than among people without such exposure, although the CIs were wide and chance cannot be excluded as an explanation for these findings. Never-smokers (RR = 1.47, 95% CI = 1.34 to 1.62), former smokers (RR = 1.22, 95% CI = 1.07 to 1.39) and current smokers (RR = 1.31, 95% CI = 1.10 to 1.56) exposed to ETS were all more likely to report a less than very good health status than were people without such exposure.

CONCLUSIONS

This study demonstrates that never-smoking adults exposed to ETS report more acute health effects than unexposed, never-smoking adults, and suggests similar findings in current and former smoking adults.