December 2015

Overview

The quality of the environment directly affects health status and plays a major role in quality of life, years of healthy life lived, and health disparities. According to the World Health Organization, globally in 2004, nearly one-quarter of all deaths and the total disease burden could be attributed to environmental factors.¹

Poor air quality is linked to premature death, cancer, and long-term damage to respiratory and cardiovascular systems. Secondhand smoke is a contributor to poor air quality and contains toxic and cancer-causing chemicals that contribute to heart disease and lung cancer in non-smoking adults.¹

There is no risk-free level of exposure to secondhand smoke. Secondhand smoke causes heart disease and lung cancer in adults and a number of health problems in infants and children, including: severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome (SIDS).²

Despite falling smoking rates over the past 50 years, 58 million non-smokers in the United States, including 15 million children ages 3–11 years, were exposed to secondhand tobacco smoke in 2011–12. Among non-smokers of all ages, 1 in 4 were exposed to secondhand smoke.³

Maintaining a healthy environment is central to increasing quality of life and years of healthy life. An environment free of hazards, such as secondhand smoke, carbon monoxide, allergens, lead, and toxic chemicals, helps prevent disease and other health problems.¹

Learn More About Environmental Quality

Leading Health Indicators

Leading Health Indicators (LHIs) are critical health issues that—if tackled appropriately—will dramatically reduce the leading causes of death and preventable illnesses. The Environmental Quality LHIs are:

• Air Quality Index (AQI) exceeding 100 (EH-1)
• Children exposed to secondhand smoke (TU-11.1)

Where We’ve Been and Where We’re Going

The Air Quality Index (AQI), which reports daily air quality from a value of 0 to 500, considers values greater than 100 to indicate unhealthy levels of air pollution. Between 2006–2008 and 2009–2011, potential exposure to unhealthy air quality (measured as the number of AQI-weighted people days) decreased 44%, exceeding the HP2020 target. However, air quality, as measured by AQI, is highly dependent on local, seasonal, and annual variation in weather.

Between 2005–08 and 2009–12, exposure to secondhand smoke among children aged 3–11 years decreased 21%, from 52.2% to 41.3%, also exceeding the HP2020 target. In 2009–12, several groups of children in specific demographic categories had the lowest rates of secondhand smoke exposure, including Hispanic children, those born outside the U.S., those with private health insurance, and those in families with incomes 500% or more of the poverty threshold.

Considering the full age spectrum of non-smokers, children aged 3–11 years had higher secondhand smoke exposure (41.3%) than adolescents aged 12–17 years (33.6%) or adults aged 18 years and older (24.8%) in 2009–12.

Who’s Leading the Leading Health Indicators?

Nearly 5,000 Take “Smoke-Free Homes Pledge” in Maine

Tobacco smoke contains more than 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer.⁴ In Maine, exposure to secondhand smoke remains a serious public health problem. Allowing smoking to occur inside the home increases the probability of exposure of children and adolescents to secondhand smoke. In 2015, 25.4% of middle school youth and 34.4% of high school youth reported having been in the same room with someone who was smoking cigarettes sometime during the past week.⁵

In 1997, Maine increased its cigarette excise tax from $0.37 to $0.74 and used a portion of those funds to establish a comprehensive tobacco prevention program known as the Partnership for a Tobacco-Free Maine. The Partnership for a Tobacco-Free Maine’s mission is to reduce disability, disease, and death due to tobacco use and exposure among Maine citizens. Maine has subsequently augmented its program with proceeds from a state tobacco settlement, which also resulted in a further increase in cigarette taxes. Maine raised cigarette taxes to $1.00 per pack in 2001 and $2.00 per pack in 2005. In an effort to address secondhand smoke exposure in their state, the Partnership for a Tobacco-Free Maine and the Maine Center for Disease Control and Prevention (CDC) fund the City of Portland’s Breathe Easy Coalition of Maine, which seeks to promote strong voluntary policies that lead to reduced tobacco use and involuntary exposure to secondhand smoke.⁶

Read the Full Story

Leading Health Indicator Infographic

¹ Prüss-Üstün A, Corvalán C. Preventing Disease through Healthy Environments. Geneva, Switzerland: World Health Organization; 2006. Available from http://www.who.int/quantifying_ehimpacts/publications/preventingdisease.pdf

² Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta: CDC; 2006. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/2006/index.htm

³ http://www.cdc.gov/tobacco/data_statistics/vital_signs/index.htm

⁴ U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services; 2014 [accessed 2015 Dec 7].

⁵ Maine Center for Disease Control and Prevention. Maine Integrated Youth Health Survey. 2015.

⁶ http://breatheeasymaine.org/members/

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