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TU-11.2 Data Details

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TU-11.2 Reduce the proportion of adolescents aged 12 to 17 years exposed to secondhand smoke

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): 
45.5 (2005–08)
Target: 
41.0
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of nonsmokers aged 12 to 17 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 12 to 17 years

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From 2005 National Health and Nutrition Examination Survey:

    [NUMERATOR AND DENOMINATOR:]

    [For ages 12 years and older:]

    During the past 5 days did you use any product containing nicotine including cigarettes, pipes, cigars, chewing tobacco, snuff, nicotine patches, nicotine gum, or any other product containing nicotine?

    1. Yes
    2. No
    3. Refused
    4. Don't know
Data Collection Frequency: 
Periodic
Methodology Notes: 

    Adolescents aged 12 to 17 years are classified as nonsmokers if they respond “no” to using any product containing nicotine in the past 5 days and if their serum cotinine level is less than or equal to 10 ng/mL. Only responses to the questions asked of persons who participated in the examination component of the survey were used, so that serum levels of cotinine could be available for analysis.

    The limit of detection for cotinine was revised to 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’.

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 78.0% to 45.5%. The target was adjusted from 70.2% to 41.0% 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.