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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Reduce the proportion of people who don't smoke but are exposed to secondhand smoke — TU‑19 Data Methodology and Measurement

On this page:  About the National Data  |  Methodology  |  History

About the National Data

Data

Data Source:  National Health and Nutrition Examination Survey (NHANES), CDC/NCHS

Baseline: 25.6 percent of children aged 3 to 11 years, nonsmoking adolescents aged 12 to 17 years, and nonsmoking adults aged 18 years and over were exposed to secondhand smoke in 2013-16

Target: 17.4 percent

Numerator
Number of children, nonsmoking adolescents, and nonsmoking adults aged 3 years and over who had a serum cotinine level greater than or equal to 0.05 ng/mL and less than or equal to 10 ng/ml.
Denominator
Number of children, nonsmoking adolescents, and nonsmoking adults aged 3 years and over.
Target-setting method
Percentage point improvement
Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.20.
1
Target-setting method justification
Trend data were evaluated for this objective, but it was not possible to project a target because the projection was a negative value and not realistic. A percentage point improvement was calculated using Cohen's h effect size of 0.2. This method was used because an accelerated decline was expected based on the trend data.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From 2013 National Health and Nutrition Examination Survey:

Numerator and Denominator:
[For ages 12 years and older]:
During the past 5 days, including today, did you smoke cigarettes, pipes, cigars, little cigars or cigarillos, water pipes, hookahs, or e-cigarettes?
  1. Yes
  2. No
  3. REFUSED
  4. DON'T KNOW
During the past 5 days, did you use any smokeless tobacco?
  1. Yes
  2. No
  3. REFUSED
  4. DON'T KNOW
[For ages 18 years and older]:
During the past 5 days, including today, did you use any nicotine replacement therapy products such as nicotine patches, gum, lozenges, inhalers, or nasal sprays?
  1. Yes
  2. No
  3. REFUSED
  4. DON'T KNOW

Methodology notes

Children aged 3 to 11 years are classified as nonsmokers if they have a serum cotinine level less than or equal to 10 ng/mL.

Adolescents (aged 12-17 years) were classified as nonsmokers if they did not report using any nicotine-containing products (cigarettes, pipes, cigars, little cigars or cigarillos, water pipes, hookahs, e-cigarettes or smokeless tobacco products) within the preceding 5 days and if their serum cotinine level is less than or equal to 10 ng/mL.

Adults (aged 18 years and over) are classified as nonsmokers if they did not report using any nicotine-containing tobacco product (cigarettes, pipes, cigars, little cigars or cigarillos, water pipes, hookahs, or e-cigarettes, or smokeless tobacco products) or nicotine replacement therapy (nicotine patches, gum, lozenges, inhalers, or nasal sprays) within the preceding 5 days and if their serum cotinine level is less than or equal to 10 ng/mL.

For respondents aged 12 and older, only responses to the questions asked of participants in the examination component were used so that serum cotinine levels could be used for the analysis. The limit of detection used for cotinine is 0.05 ng/mL. This indicator uses age-adjustment groups: 3-11; 12-19; 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+.

Age-adjustment notes

This Indicator uses Age-Adjustment Groups:

  • Total: 3-11,12-19,20-29,30-39,40-49,50-59,60-69,70-79,80+
  • Sex: 3-11,12-19,20-29,30-39,40-49,50-59,60-69,70-79,80+
  • Race/Ethnicity: 3-11,12-19,20-29,30-39,40-49,50-59,60-69,70-79,80+
  • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Family Income (percent poverty threshold): 3-11,12-19,20-29,30-39,40-49,50-59,60-69,70-79,80+
  • Country of Birth: 3-11,12-19,20-29,30-39,40-49,50-59,60-69,70-79,80+
  • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 3-11,12-19,20-29,30-39,40-49,50-59,60-64
  • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

History

Comparable HP2020 objective
Modified, which includes core objectives that are continuing from Healthy People 2020 but underwent a change in measurement.
Changes between HP2020 and HP2030
This objective differs from the related Healthy People objectives in that it is a composite of objectives TU-11.1, TU-11.2, and TU-11.3, which tracked exposure to secondhand smoke among children aged 3 to 11 years, adolescents aged 12 to 17 years, and adults aged 18 years and over, respectively.
Revision History
Revised. 

The baseline data for TU-19 were re-run to add the HP2030 standard template data, At that time there was a small adjustment in the age adjustment groups used to align with our guidance on age adjusting NHANES objectives. The age adjustment groups were changed from: (3-17, 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+) to: (3-11,12-19,20-29,30-39,40-49,50-59,60-69,70-79,80+). As a result, in 2024 the baseline was revised from 25.5% to 25.6% in 2013-2016.

As a result of the change in the baseline, the target was revised from 17.3% to 17.4% using the original target setting method.

The baseline statement was further revised to align with the age groups used in the methodology to reduce confusion on the measure.

1. Effect size h=0.2 was chosen to correspond with 20% improvement from a baseline of 50%.