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December 2013
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Overview
Exposure to outdoor and indoor air pollution can cause both short-term and long-term health effects, including damage to the immune, neurological, reproductive, cardiovascular, and respiratory systems. Poor outdoor air quality can be attributed to both natural sources of pollution, such as dust from windstorms, as well as human generated sources, such as emissions from vehicles. While many factors contribute to poor indoor air quality, secondhand smoke is one of the most pervasive of these pollutants.
In the United States during 2007-2008, approximately 88 million non-smokers aged 3 and over were exposed to secondhand smoke.1 There is no risk-free level of exposure to secondhand smoke, which causes numerous health problems for both children and adults. These health problems include asthma attacks, respiratory infections, and sudden infant death syndrome (SIDS) in children, and heart disease and lung cancer in adults.2 Although many states and communities have passed laws to help reduce exposure to secondhand smoke, millions of children and adults still breathe secondhand smoke in their homes, cars, workplaces, and in public places.3
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Environmental Quality and the Affordable Care Act
The Health Insurance Marketplace offers a new way for individuals, families, and small businesses to get health coverage and obtain access to a variety of essential health benefits and preventive services. These services include tobacco cessation interventions which not only help people quit smoking, but also help to reduce exposure to secondhand smoke in homes and public places. Visit healthcare.gov to learn more about the benefits of the Affordable Care Act.
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Leading Health Indicators
Leading Health Indicators (LHI) are critical health issues that – if tackled appropriately – will dramatically reduce the leading causes of death and preventable illnesses. The LHIs for Environmental Quality are:
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Where We’ve Been and Where We’re Going
Between 2005-2008 and 2009-2012, exposure to secondhand smoke among children aged 3 to 11 years decreased 20.9%, from 52.2% to 41.3%, exceeding the HP2020 target of 47.0%. Exposure to secondhand smoke varies by race and ethnicity, country of birth, and health insurance status. 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. The Healthy People 2020 objective assesses changes in air quality by considering both the number and severity of unhealthy days, and weighing them by population and AQI. Between 2006-2008 and 2009-2011 the number of AQI-weighted people days has decreased 44%, also exceeding the HP2020 target.
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Who’s Leading the Leading Health Indicators?
Freedom to Breathe Act — One Coalition’s Work to Clear the Air for the People of Minnesota
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 In 2007, 56.7 percent of adults in Minnesota reported exposure to secondhand smoke during the past week.4 A statewide coalition of tobacco control stakeholders was formed to address the harmful effects of secondhand smoke. Led by the Minnesota Department of Health (MDH), Blue Cross Blue Shield, and ClearWay Minnesota, an independent, nonprofit organization created in 1998 to enhance life in Minnesota by using research, action, and collaboration to reduce tobacco use and exposure to secondhand smoke, the coalition worked to pass the Freedom to Breathe Act.
Minnesota’s Freedom to Breathe Act, which amended the Minnesota Clean Indoor Air Act, prohibits smoking in all indoor public places and indoor places of employment, protecting employees and the general public from the hazards of secondhand smoke. MDH and ClearWay Minnesota gathered information about the attitudes of Minnesotans towards smoke-free laws and conducted additional research on smoke-free policies to inform the debate.
MDH and ClearWay Minnesota utilize multiple strategies to reduce secondhand smoke exposure, including public education and media, tribal grants, and policy grants. Many of these local and tribal grantees have succeeded in implementing smoke-free policies. For instance, White Earth Nation, a tribal grantee funded by MDH, successfully implemented smoke-free Powwow policies at their annual Powwow and supported enforcement of smoke-free policies at all schools in their jurisdiction.
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