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Int. J. Environ. Res. Public Health 2016, 13(11), 1048;

Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults—National Adult Tobacco Survey, 2009–2010 and 2013–2014

Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
DB Consulting Group, Atlanta, GA 30329, USA
Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Author to whom correspondence should be addressed.
Academic Editors: Laura L. Jones and Amanda Farley
Received: 18 July 2016 / Revised: 20 October 2016 / Accepted: 21 October 2016 / Published: 26 October 2016
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
Full-Text   |   PDF [275 KB, uploaded 28 October 2016]


In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009–2010 and 2013–2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009–2010 to 2013–2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p < 0.05). Among nonsmokers, SHS exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = −10.9%; p < 0.05). Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms. View Full-Text
Keywords: tobacco products; secondhand smoke exposure; vehicles; policy tobacco products; secondhand smoke exposure; vehicles; policy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Kruger, J.; Jama, A.; Kegler, M.; Baker Holmes, C.; Hu, S.; King, B. Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults—National Adult Tobacco Survey, 2009–2010 and 2013–2014. Int. J. Environ. Res. Public Health 2016, 13, 1048.

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