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Survey Items: Survey instrument item number for children 0-5 years: I2; for children 6-11 years: I2; for children 12-17 years: I2 Variable in public use data file: K9Q40
Denominator: Children age 0-17 years
Numerator: Someone in household smokes; No one in household smokes
Revisions and Changes: The survey item for this measure has not changed since 2016.
Additional Notes: This measure was derived from a single item. Please note that results for this question are weighted to reflect the population of children ages 0-17, not the population of parents or families. Results should be reported as: "Percent of children who live in the household where someone smokes…" not as "Percent of families….” For more information on the Title V MCH Block Grant measures, review this document.
Treatment of Unknown Values: Missing values may be due to non-response (i.e. a skipped item) or a “don’t know” response. The way these items are handled can vary by measure. For NPMs and NOMs, having missing values for all items in an indicator will lead to the case being given a missing value on the overall measure. For some other measures, if there is a missing value on any of the items, the case will be set to missing. How missing values are handled is documented in the "Additional notes" field above when required. Missing values are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the Interactive Data Query results table. In the majority of cases, the proportion of missing values is less than 5%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). To learn about the impact of the missing values on the population count estimates, click here.
History and Development: Overview of the Title V Block Grant The Title V Maternal and Child Health (MCH) Services Block Grant Program is a federal-state partnership to improve the health and well-being of mothers, children--including children with special health care needs--and their families in all 59 states and jurisdictions. The Title V MCH Services Block Grant Performance Measure Framework enables states to demonstrate the impacts of Title V within a state. The performance measurement system utilizes national data sources, including the NSCH, to track the ultimate outcomes of the program -- National Outcome Measures (NOMs) – and the key metrics of health behavior or health care access and quality -- National Performance Measures (NPMs) -- that influence NOMs. In 2024, the Title V NPMs and NOMs were updated. Some measures have new denominators (subsets of children), and some new measures have been added. Some measures are no longer NPMs and NOMs and are now classified as Standardized Measures. In 2024, MCHB expanded the definition of children with special health care needs (CSHCN). In addition to the CSHCN Screener, the denominator now includes children with at least one health condition and one functional difficulty asked in the NSCH. More information about the Title V MCH Services Block Grant and performance measurement system can be obtained at the MCHB website. Learn more about the NPM and NOM content changes at the MCHB website and DRC website. About the NSCH The National Survey of Children’s Health (NSCH), funded and directed by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB), is designed to provide annual national- and state-level information on the health and well-being of children ages 0-17 years in the United States. The U.S. Census Bureau administers the survey, oversees the sampling, and produces a final dataset. HRSA’s Maternal and Child Health Bureau (MCHB) develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. In 2016, the NSCH underwent a significant redesign which combined content from both the NSCH and the National Survey of Children with Special Health Care Needs (NS-CSHCN). Combining or comparing data from before and after the redesign is not recommended. Further information on that redesign can be found in “The Design and Implementation of the 2016 National Survey of Children’s Health”. The NSCH is conducted as a household survey, and one child per household is selected to be the subject for the detailed, age-specific questionnaire. The respondent to this questionnaire is a parent or guardian who is living in the home and has knowledge of the sampled child. Survey participants complete either web-based or self-administered paper-and-pencil questionnaires. Data from the NSCH is used for scientific research, federal policy and program development, and state-level planning and performance reporting. Information is collected on factors related to the health and well-being of children, including access to and utilization of health care, receipt of care in a medical home, systems of care for CSHCN, family interactions, parental health, school and after-school experiences, and neighborhood characteristics. More information about the survey can be found in the “About the National Survey of Children's Health” section of this website and HRSA’s MCHB website.
Overview of the Title V Block Grant
The Title V Maternal and Child Health (MCH) Services Block Grant Program is a federal-state partnership to improve the health and well-being of mothers, children--including children with special health care needs--and their families in all 59 states and jurisdictions. The Title V MCH Services Block Grant Performance Measure Framework enables states to demonstrate the impacts of Title V within a state. The performance measurement system utilizes national data sources, including the NSCH, to track the ultimate outcomes of the program -- National Outcome Measures (NOMs) – and the key metrics of health behavior or health care access and quality -- National Performance Measures (NPMs) -- that influence NOMs. In 2024, the Title V NPMs and NOMs were updated. Some measures have new denominators (subsets of children), and some new measures have been added. Some measures are no longer NPMs and NOMs and are now classified as Standardized Measures. In 2024, MCHB expanded the definition of children with special health care needs (CSHCN). In addition to the CSHCN Screener, the denominator now includes children with at least one health condition and one functional difficulty asked in the NSCH.
More information about the Title V MCH Services Block Grant and performance measurement system can be obtained at the MCHB website. Learn more about the NPM and NOM content changes at the MCHB website and DRC website.
About the NSCH
The National Survey of Children’s Health (NSCH), funded and directed by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB), is designed to provide annual national- and state-level information on the health and well-being of children ages 0-17 years in the United States. The U.S. Census Bureau administers the survey, oversees the sampling, and produces a final dataset. HRSA’s Maternal and Child Health Bureau (MCHB) develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. In 2016, the NSCH underwent a significant redesign which combined content from both the NSCH and the National Survey of Children with Special Health Care Needs (NS-CSHCN). Combining or comparing data from before and after the redesign is not recommended. Further information on that redesign can be found in “The Design and Implementation of the 2016 National Survey of Children’s Health”.
The NSCH is conducted as a household survey, and one child per household is selected to be the subject for the detailed, age-specific questionnaire. The respondent to this questionnaire is a parent or guardian who is living in the home and has knowledge of the sampled child. Survey participants complete either web-based or self-administered paper-and-pencil questionnaires. Data from the NSCH is used for scientific research, federal policy and program development, and state-level planning and performance reporting. Information is collected on factors related to the health and well-being of children, including access to and utilization of health care, receipt of care in a medical home, systems of care for CSHCN, family interactions, parental health, school and after-school experiences, and neighborhood characteristics.
More information about the survey can be found in the “About the National Survey of Children's Health” section of this website and HRSA’s MCHB website.
Indicator 6.4: Does anyone living in this child’s household use cigarettes, cigars, or pipe tobacco?
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Notes: Click on the Column Header to sort the results by ascending or descending order. To get a detailed explanation of the data HOVER over the text in the table.
Data Source: National Survey of Children’s Health, Health Resources and Services Administration, Maternal and Child Health Bureau. https://mchb.hrsa.gov/data/national-surveys
Citation: Child and Adolescent Health Measurement Initiative. 2023-2024 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [mm/dd/yy] from [www.childhealthdata.org].