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TU-11.1 Data Details

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TU-11.1 Reduce the proportion of children aged 3 to 11 years exposed to secondhand smoke
LHI

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
52.2 (2005–08)
Target: 
47.0
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of nonsmokers aged 3 to 11 years 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 non-smokers aged 3 to 11 years.

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Data Collection Frequency: 
Periodic
Leading Health Indicator:
Tobacco Use
Methodology Notes: 

    Children aged 3 to 11 years are classified as nonsmokers if they have a serum cotinine level less than or equal to 10ng/mL. The limit of detection used for cotinine is 0.05 ng/mL to be more consistent with other similar measures including indicators from Healthy People 2010 and the National Prevention Strategy. Using a lower level of detection of cotinine, may have allowed us to detect cotinine in persons who are currently categorized as ‘unexposed’.

    According to the 2006 Surgeon General’s Report, more than 126 million nonsmoking Americans had detectable serum cotinine levels as of 1999–2002. Moreover, significant population disparities continue to exist and are in some cases widening. For example, children are more heavily exposed than nonsmoking adults.

Trend Issues: 
Two-year data are used as a placeholder to provide the latest data available and will be replaced with four-year data when available. Two-year and four-year data are not comparable. Two-year estimates are generally less stable and reliable than four-year estimates.
Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 27-10 in several ways. First, the Healthy People 2010 objective language has been modified from, 'Reduce the proportion of nonsmokers exposed to environmental tobacco smoke' to 'Reduce the proportion of nonsmokers exposed to secondhand smoke'. Second, in Healthy People 2010, a single age group (persons aged 4 years and over) was monitored. Healthy People 2020 includes three objectives which assess exposure for persons aged 3 to 11 years, 12 to 17 years, and 18 years and over. Finally, the Healthy People 2010 objective did not use an upper limit for non-smokers cotinine levels. The Healthy People 2020 objectives include an upper limit of 10ng/mL. Persons with cotinine levels greater than 10 ng/mL could have been counted as exposed non-smokers in Healthy People 2010; but for Healthy People 2020 these persons are considered to be smokers.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
The limit of detection for cotinine used for the baseline at launch was 0.015ng/mL. The measure was revised in 2011 to use a limit of detection for cotinine of 0.05ng/mL, to be more consistent with similar measures including indicators from Healthy People 2010 and the National Prevention Strategy. As a result of this change, the original baseline was revised from 82.2% to 52.2%. The target was adjusted from 74.0% to 47.0% to reflect the revised baseline using the original target-setting method.

References

Additional resources about the objective

  1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. 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, 2006.