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People in All Geographic Areas Need More Protection from Secondhand Smoke										Related Pages
										The CDC is focused on protecting all people from health risks—including secondhand smoke (SHS), or the smoke produced when commercial tobacco* is burned—where they work, live, and play. There is no safe level of exposure to SHS.1Uneven access to smokefree laws and policies drives health inequities.26 Smokefree air policies are important for public health because they protect people who don’t smoke from SHS, motivate those who smoke to quit, and prevent people from starting to smoke. Right now, however, not everyone in the nation is equitably protected by these policies. Progress in smokefree protections have been blocked for some geographic regions and communities within them.
In some states, communities having residents with less education and lower incomes are less likely to be covered by comprehensive smokefree laws that prohibit smoking in all areas of workplaces, restaurants, and bars.27
In some states, urban areas are more likely than rural areas to have comprehensive smokefree laws.27Actions that can protect all people from SHS include:No Smoking in the building icon**Make all workplaces smokefree—with no exceptions.**Many workplaces are now covered by a smokefree law—but certain types of workers are not included, leaving them exposed to preventable health hazards. Gaps in smokefree protections often leave out the places where some rural residents work, such as restaurants, bars, casinos, farms, and workplaces with fewer than five employees.28No smoking home icon**Let local communities create stronger smokefree air policies.** One in five people who isn’t protected by a smokefree policy lives in a state that does not allow local communities to adopt their own smokefree laws.29 Letting local governments adopt stronger protections than the state would let more communities protect residents from SHS.26
**“Commercial tobacco” means harmful products that are made and sold by tobacco companies. It does not include “traditional tobacco” used by Indigenous groups for religious or ceremonial purposes*.
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U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General [PDF – 9.8 MB]. Atlanta, GA: 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, 2020 [accessed 2022 Mar 22].
Henriksen L, Schleicher NC, Johnson TO, Roeseler A, Zhu SH. Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices. Health Promotion Practice. 2020; 21(1_suppl):27S-36S [accessed 2022 Mar 22].
Pamela M. Ling, Lawrence A. Haber, and Stefani Wedl. Branding the Rodeo: A Case Study of Tobacco Sports Sponsorship. American Journal of Public Health. 2010; 100, 32_41 [accessed 2022 Apr 28].
Ling PM, Haber LA, Wedl S. Branding the rodeo: a case study of tobacco sports sponsorship. American Journal of Public Health. 2010;100(1):32-41 [accessed 2022 Mar 22].
Hall J, Cho HD, Maldonado-Molina M, George Jr TJ, Shenkman EA, Salloum RG. Rural-urban disparities in tobacco retail access in the southeastern United States: CVS vs. the dollar stores.  Preventive Medicine Reports. 2019;15, 100935 [accessed 2022 Mar 22].
Robertson L, McGee R, Marsh L, Hoek J. A systematic review on the impact of point-of-sale tobacco promotion on smoking. Nicotine & Tobacco Research. 2015;17(1): 2-17 [accessed 2022 Mar 22].
Hafez AY, Gonzalez M, Kulik MC, Vijayaraghavan M, Glantz SA. Uneven access to smoke-free laws and policies and its effect on health equity in the United States: 2000–2019. American Journal of Public Health. 2019;109(11): 1568-1575 [accessed 2022 Mar 22].
Huang J, King BA, Babb SD, Xu X, Hallett C, Hopkins M. Sociodemographic Disparities in Local Smoke-Free Law Coverage in 10 States. American Journal of Public Health. 2015;105(9):1806-13 [accessed 2022 Mar 22].
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							Last Reviewed:  January 26, 2023						Source: 	Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
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