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Maggs JL, Staff J, Mongilio JM, Miller SE, Vuolo M, Kelly BC. Risk Factors for E-Cigarette Ban Relaxation in Homes With Adolescents. J Adolesc Health 2024:S1054-139X(24)00242-8. [PMID: 39007788 DOI: 10.1016/j.jadohealth.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE To identify risk factors for relaxing a strict e-cigarette ban in households with adolescents. METHODS Youth (ages 12-17) in the Population Assessment of Tobacco and Health (PATH) Study whose parents held a strict vaping ban in 2016 (n = 6,514; 51.5% male) and their parents provided follow-up data on up to four occasions through 2020 on whether the ban was relaxed. RESULTS 13.5% of households with strict vaping bans relaxed them in a subsequent wave. Results from a logistic regression model showed that the odds of relaxing strict bans were higher if, at baseline, parents vaped (OR = 2.20; 95% CI: 1.22-3.97; p < .01), parents smoked tobacco (OR = 2.55; CI: 2.00-3.26; p < .001), youth smoked tobacco (OR = 2.27; CI: 1.29-4.00; p < .01), parents reported no smoking ban (OR = 2.68; CI: 1.88-3.81; p < .001), youth did not know that their household had a vaping ban (OR = 1.95; CI: 1.50-2.54; p < .001), and parents perceived low harm from vaping (OR = 1.60; CI: 1.16-2.19; p < .01). Although most sociodemographic controls were not independently associated, parents were less likely to relax bans if they had a college degree (OR = 0.71; CI: 0.51-0.998; p < .05), graduate degree (OR = 0.50; CI: 0.43-0.72; p < .001), or children who were non-Hispanic Black (OR = 0.69; CI: 0.49-0.96; p < .05) or Hispanic (OR = 0.62; CI: 0.47-0.81; p < .001). DISCUSSION While most households with adolescents prohibited e-cigarette use indoors, nearly one in seven relaxed prior strict vaping bans. Parents need support to maintain clear, consistent, and continuous restrictions that communicate that vaping is not safe or permissible for youth.
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Affiliation(s)
- Jennifer L Maggs
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania.
| | - Jeremy Staff
- Department of Sociology and Criminology, Pennsylvania State University, University Park, Pennsylvania
| | - Jessica M Mongilio
- Department of Sociology and Criminology, Pennsylvania State University, University Park, Pennsylvania
| | - Sara E Miller
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania
| | - Mike Vuolo
- Department of Sociology, The Ohio State University, Columbus, Ohio
| | - Brian C Kelly
- Department of Sociology, Purdue University, West Lafayette, Indiana
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DeSerisy M, Cohen JW, Dworkin JD, Stingone JA, Ramphal B, Herbstman JB, Pagliaccio D, Margolis AE. Early life stress, prenatal secondhand smoke exposure, and the development of internalizing symptoms across childhood. Environ Health 2023; 22:58. [PMID: 37620883 PMCID: PMC10463722 DOI: 10.1186/s12940-023-01012-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Prior findings relating secondhand tobacco smoke (SHS) exposure and internalizing problems, characterized by heightened anxiety and depression symptoms, have been equivocal; effects of SHS on neurodevelopment may depend on the presence of other neurotoxicants. Early life stress (ELS) is a known risk factor for internalizing symptoms and is also often concurrent with SHS exposure. To date the interactive effects of ELS and SHS on children's internalizing symptoms are unknown. We hypothesize that children with higher exposure to both prenatal SHS and ELS will have the most internalizing symptoms during the preschool period and the slowest reductions in symptoms over time. METHODS The present study leveraged a prospective, longitudinal birth cohort of 564 Black and Latinx mothers and their children, recruited between 1998 and 2006. Cotinine extracted from cord and maternal blood at birth served as a biomarker of prenatal SHS exposure. Parent-reported Child Behavior Checklist (CBCL) scores were examined at four timepoints between preschool and eleven years-old. ELS exposure was measured as a composite of six domains of maternal stress reported at child age five. Latent growth models examined associations between SHS, ELS, and their interaction term with trajectories of children's internalizing symptoms. In follow-up analyses, weighted quintile sum regression examined contributions of components of the ELS mixture to children's internalizing symptoms at each time point. RESULTS ELS interacted with SHS exposure such that higher levels of ELS and SHS exposure were associated with more internalizing symptoms during the preschool period (β = 0.14, p = 0.03). The interaction between ELS and SHS was also associated with a less negative rate of change in internalizing symptoms over time (β=-0.02, p = 0.01). Weighted quintile sum regression revealed significant contributions of maternal demoralization and other components of the stress mixture to children's internalizing problems at each age point (e.g., age 11 WQS β = 0.26, p < 0.01). CONCLUSIONS Our results suggest that prior inconsistencies in studies of SHS on behavior may derive from unmeasured factors that also influence behavior and co-occur with exposure, specifically maternal stress during children's early life. Findings point to modifiable targets for personalized prevention.
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Affiliation(s)
- Mariah DeSerisy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Jacob W Cohen
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jordan D Dworkin
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Bruce Ramphal
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - David Pagliaccio
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Amy E Margolis
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
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Merianos AL, Jacobs W, Olaniyan AC, Smith ML, Mahabee‐Gittens EM. Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1202-1213. [PMID: 35989183 PMCID: PMC9669117 DOI: 10.1111/josh.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Tobacco smoke exposure (TSE), defined as secondhand smoke (SHS) and thirdhand smoke (THS), is associated with negative health consequences. This study's objective was to assess the associations between home TSE status and school engagement, school success, and afterschool activity participation among school-aged children. METHODS We conducted a secondary analysis of 2018-2019 National Survey of Children's Health cross-sectional data. Children ages 6-11 years (N = 17,466) were categorized into home TSE groups: no home TSE; THS exposure only; and SHS and THS exposure. Weighted logistic and Poisson regression models were built. RESULTS Compared to children with no home TSE, children with home THS exposure only and SHS and THS exposure were at decreased odds of being engaged in school (AOR = 0.69, 95%CI = 0.57, 0.83; AOR = 0.63, 95%CI = 0.41, 0.97, respectively), and at increased odds of having ≥1 school-to-home contact about child problems in school (AOR = 1.83, 95%CI = 1.50, 2.23; AOR = 1.58, 95%CI = 1.05, 2.37, respectively). Children with THS exposure only were at increased odds of missing ≥1 school day (AOR = 1.43, 95%CI = 1.13, 1.81). Children with THS exposure only (ARR = 0.90, 95%CI = 0.83, 0.96) and SHS and THS exposure (ARR = 0.74, 95%CI = 0.61, 0.89) were at reduced likelihood of participating in a higher number of afterschool activities. CONCLUSIONS Children exposed to home tobacco smoke are at unique risk for poorer school engagement and success.
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Affiliation(s)
- Ashley L. Merianos
- University of Cincinnati, School of Human ServicesPO Box 210068CincinnatiOH45221‐0068
| | - Wura Jacobs
- Department of KinesiologyCalifornia State University Stanislaus, One University CircleTurlockCA95382
| | - Afolakemi C. Olaniyan
- University of Cincinnati, School of Human ServicesPO Box 210068CincinnatiOH45221‐0068
| | - Matthew Lee Smith
- School of Public Health, Texas A&M University212 Adriance Lab RoadCollege StationTX77843
| | - E. Melinda Mahabee‐Gittens
- Cincinnati Children's Hospital Medical Center, Division of Emergency MedicineCollege of Medicine, University of Cincinnati3333 Burnet Avenue, MLC 2008, 3333 Burnet AvenueCincinnatiOH45229
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Mohindra M, Hernández D. "I think everybody will have to get together for it to work": NYCHA Tenant Perspectives on HUD's 2018 Smoke-Free Mandate Captured Prior to Policy Implementation. Nicotine Tob Res 2022; 24:1654-1660. [PMID: 35325238 PMCID: PMC9575971 DOI: 10.1093/ntr/ntac076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION In July 2018, a new federal mandate by the Department of Housing and Urban Development went into effect requiring all US public housing authorities to implement policies banning smoking in living units, indoor common areas, administrative buildings, and outdoor areas within 25 feet of these buildings. Although some housing authorities had smoke-free policies in place for decades, others had to implement them for the first time. Housing authorities continue to face challenges in ensuring compliance with these policies, and resident perspectives can greatly inform measures to promote adherence. AIMS AND METHODS We conducted in-person interviews with 20 New York City Housing Authority tenants in April 2018. Our thematic analysis examined resident opinions on the upcoming smoke-free housing policy. RESULTS Although 65% of residents supported the policy, 50% anticipated poor adherence due to expected lack of enforcement, safety issues with smoking outdoors, and general discontent with the housing authority and living conditions. However, many participants felt adherence could be improved if the housing authority optimized resource-provision and communication with tenants. CONCLUSIONS Our study adds to existing literature examining tenant views on the controversial topic of mandatory smoke-free housing policies, and our interviews were conducted at a unique time prior to policy implementation in the country's largest public housing authority. Based on our results, we provide recommendations for housing authorities including: (1) information and resource-provision, (2) safety enhancement, and (3) relationship building with tenants in order to maximize policy adherence. IMPLICATIONS Our study is unique because we captured resident views prior to policy implementation in a housing authority without a preexisting smoke-free policy in place. In comparison, most recent research on this topic has focused on the postimplementation period or used survey research methods in the preimplementation phase. Our findings add to extant research about tenant perspectives on smoke-free housing policies and offer suggestions to address barriers to compliance.
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Affiliation(s)
- Mandakini Mohindra
- Corresponding Author: Mandakini Mohindra, MD, MPH, Department of Medicine, University of California, San Diego, 200 W. Arbor Drive, San Diego, CA 92103-8425, USA. Telephone: (619) 543-6268; E-mail:
| | - Diana Hernández
- Sociomedical Sciences Department, Columbia University Mailman School of Public Health, New York, NY, USA
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Berardi V, Bostean G, Ong LQ, Wong BS, Collins BN, Hovell MF. The Role of Ethnicity and Nativity in the Correspondence between Subjective and Objective Measures of In-Home Smoking. J Immigr Minor Health 2022; 24:1214-1223. [PMID: 34837590 PMCID: PMC9793886 DOI: 10.1007/s10903-021-01307-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 12/30/2022]
Abstract
Studies are needed to understand the association between self-reported home smoking bans and objective measures of in-home smoking according to smokers' ethnicity/nativity. Data came from a trial that used air particle monitors to reduce children's secondhand smoke exposure in smokers' households (N = 251). Linear regressions modeled (a) full home smoking bans by ethnicity/nativity, and (b) objectively measured in-home smoking events, predicted by main and interaction effects of self-reported home smoking bans and ethnicity/nativity. Among smokers reporting < a full ban, US-born and Foreign-born Latinos had fewer in-home smoking events than US-born Whites (p < 0.001). Participants who reported a full smoking ban had a similar frequency of smoking events regardless of ethnicity/nativity. Results indicate that self-reported home smoking bans can be used as a proxy for in-home smoking. Establishing smoking bans in the households of US-born White smokers has the largest impact on potential exposure compared to other ethnicity/nativity groups.
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Affiliation(s)
- Vincent Berardi
- Department of Psychology, Chapman University, Orange, CA, USA
| | - Georgiana Bostean
- Department of Sociology & Environmental Science & Policy Program, Chapman University, Orange, CA, USA
| | - Lydia Q. Ong
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Britney S. Wong
- Graduate School of Education & Psychology, Pepperdine University, Los Angeles, CA, USA
| | - Bradley N. Collins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Melbourne F. Hovell
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
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Mantey DS, Omega-Njemnobi O, Hunt ET, Lanza K, Cristol B, Kelder SH. Home Smoke-Free Policies as Children Age: Urban, Rural, and Suburban Differences. Nicotine Tob Res 2022; 24:1985-1993. [PMID: 35901848 PMCID: PMC9653085 DOI: 10.1093/ntr/ntac186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/30/2022] [Accepted: 07/26/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Parents/guardians can effectively reduce tobacco smoking and secondhand smoke exposure among youth by adopting and enforcing rules against indoor tobacco smoking (ie, home smoke-free policies). We investigate home smoke-free policies from childhood to adolescence in the United States and across rural, suburban, and urban households. AIMS AND METHODS We analyzed 2019-2020 National Survey of Children's Health data from n = 5,955 parents of youth aged 0-17, living at home with a tobacco smoker in the United States (U.S). Geographical categories were: rural, suburban, and urban. Home smoke-free policy reflected prohibiting tobacco smoking inside the home. Weighted logistic regressions examined the (1) association between youth age and home smoke-free policies, (2) interaction between geographic category and youth age, and (3) differing associations between youth age and home smoke-free policies by geography. Models controlled for youth race, ethnicity, sex, parental education, household annual income, and home structure. RESULTS Approximately 13.2% of U.S. households with a smoker did not have a home smoke-free policy. Stratified analyses found one-year increase in youth age was associated with lower odds of having a home smoke-free policy in rural (aOR:0.91; 95%CI: 0.87-0.95) and urban (aOR: 0.96; 95%CI: 0.92-1.00; p = .039), but not suburban (aOR:1.00; 95%CI: 0.95-1.05) households, controlling for covariates. CONCLUSION Odds of having a smoke-free home in the U.S. declined significantly in rural (9% per year) and urban (4%) but not suburban (0%) households. We quantify declines in home smoke-free policies as children age and identify geographic disparities for this environmental determinant of health. IMPLICATIONS Health promotion efforts targeting secondhand smoke prevention is needed, particularly for parents of older youth. Furthermore, there is a clear geographic bias in secondhand smoke exposure among all youth particularly older youth. Tailored interventions are needed to address geographic disparities in secondhand smoke exposure among rural and urban youth.
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Affiliation(s)
- Dale S Mantey
- Corresponding Author: Dale S. Mantey, PhD, MPA, UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA. Telephone: 254-541-2797; Fax: 512-482-6185; E-mail:
| | - Onyinye Omega-Njemnobi
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Ethan T Hunt
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Kevin Lanza
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Benjamin Cristol
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Steven H Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
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Ou Z, Gao Y, Jiang D, Cui J, Ren Y, Tang S, Duan D, Yu D, Wang Z. Global Trends in Death, Years of Life Lost, and Years Lived With Disability Caused by Breast Cancer Attributable to Secondhand Smoke From 1990 to 2019. Front Oncol 2022; 12:853038. [PMID: 35425702 PMCID: PMC9001985 DOI: 10.3389/fonc.2022.853038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/07/2022] [Indexed: 12/09/2022] Open
Abstract
Background Secondhand smoke is an important risk factor to breast cancer patients’ survival. This article aimed to describe the epidemiological changes of health loss caused by female breast cancer attributable to secondhand smoke from 1990 to 2019. Methods Data on breast cancer was derived from the Global Burden of Disease study 2019. The epidemiological status and trends were estimated using the number, age-standardized rate (ASR), and estimated annual percentage change (EAPC). Results In 2019, secondhand smoke-related breast cancer caused 168.33×102 death, 5242.58×102 years of life lost (YLLs), and 334.03×102 years lived with disability (YLDs) globally. The overall ASR of death and YLLs caused by breast cancer attributable to secondhand smoke presented decreasing trends from 1990 to 2019, with the respective EAPCs of −0.78 and −0.87. Meanwhile, decreasing trends occurred in most geographic regions, particularly that of YLLs in high-income North America (EAPC = −3.35). At the national level, most countries/territories had decreasing trends of death and YLLs, particularly Denmark, in which the respective EAPCs were −4.26 and −4.64. However, the ASR of YLDs showed an increasing trend globally (EAPC = 0.32). Meanwhile, increasing trends were observed in most regions and countries, particularly the Solomon Islands and Lesotho, with the respective EAPCs being 6.18 and 4.33. The changing trends were closely associated with sociodemographic development. Conclusions Trends in secondhand smoke-related death and YLLs caused by breast cancer declined from 1990 to 2019. However, secondhand smoke remains a challenge to the patients’ longevity and quality of life. The findings informed strategies should be strengthened the control of secondhand smoking.
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Affiliation(s)
- Zejin Ou
- Department of Central Laboratory, Guangzhou Twelfth People's Hospital, Guangzhou, China.,Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yunxia Gao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Diwei Jiang
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Jiaxin Cui
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yixian Ren
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Shihao Tang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Danping Duan
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Danfeng Yu
- Department of Medical Intensive Care Unit (MICU), Guangdong Women and Children Hospital, Guangzhou, China
| | - Zhi Wang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
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Fallavollita WL, Do EK, Schechter JC, Kollins SH, Zheng J(J, Qin J, Maguire RL, Hoyo C, Murphy SK, Fuemmeler BF. Smoke-Free Home Rules and Association with Child Secondhand Smoke Exposure among Mother-Child Dyad Relationships. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5256. [PMID: 34069235 PMCID: PMC8157188 DOI: 10.3390/ijerph18105256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 01/22/2023]
Abstract
Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother-child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.
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Affiliation(s)
- Westley L. Fallavollita
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
| | - Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Julia C. Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Junfeng (Jim) Zheng
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC 27708, USA;
| | - Jian Qin
- School of Public Health, Guangxi Medical University, Nanning 530021, China;
| | - Rachel L. Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
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Choi K, Chen-Sankey JC, Merianos AL, McGruder C, Yerger V. Secondhand Smoke Exposure and Subsequent Academic Performance Among U.S. Youth. Am J Prev Med 2020; 58:776-782. [PMID: 32147368 PMCID: PMC7246157 DOI: 10.1016/j.amepre.2019.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Previous research shows the associations between secondhand smoke exposure and health consequences among youth, but less is known about its effect on academic performance. This study examines a dose-response relationship between secondhand smoke exposure and subsequent academic performance among U.S. youth. METHODS Data were from a nationally representative sample of youth non-tobacco users (aged 12-16 years) in Wave 2 (2014-2015) who completed Wave 3 (2015-2016) of the Population Assessment of Tobacco and Health Study (n=9,020). Past-7-day number of hours exposed to secondhand smoke at Wave 2 and academic performance at Wave 3 (1=Mostly As to 9=Mostly Fs) were assessed. Weighted multivariable linear regression models were used to examine the association between hours of self-reported secondhand smoke exposure at Wave 2 and academic performance at Wave 3 (1=Mostly Fs, 9=Mostly As), adjusting for covariates including sociodemographics, prior academic performance, internalizing and externalizing problems, and substance use problems. Analyses were conducted in 2019. RESULTS More than 30% of U.S. youth non-tobacco users were exposed to secondhand smoke in the past 7 days. Compared with unexposed youth at Wave 2, those who were exposed for 1-9 hours had poorer academic performance at Wave 3 (adjusted regression coefficient= -0.11, 95% CI= -0.18, -0.04), and those who were exposed for ≥10 hours at Wave 2 had even poorer academic performance (adjusted regression coefficient = -0.31, 95% CI= -0.45, -0.18). CONCLUSIONS A dose-response relationship was observed between secondhand smoke exposure and academic performance among U.S. youth. Reducing youth secondhand smoke exposure may promote academic performance and subsequent educational attainment.
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Affiliation(s)
- Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
| | - Julia Cen Chen-Sankey
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, Ohio
| | - Carol McGruder
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
| | - Valerie Yerger
- African American Tobacco Control Leadership Council, San Francisco, California
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Montreuil A, Wellman RJ, O'Loughlin JL. Single-parent status and smoke-free home rules among daily smokers. Canadian Journal of Public Health 2019; 111:297-304. [PMID: 31858438 DOI: 10.17269/s41997-019-00274-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/18/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In Canada, the home has become the primary locale in which children are exposed to tobacco smoke. Single parents are less likely than two-parent families to ban smoking at home, but the extent to which this relates to economic inequalities across family structures is unclear. Our objective was to estimate the association between household structure (single- vs. non-single-parent family) and smoke-free home rules, accounting for indicators of economic disadvantage. METHODS Data were available in a telephone survey conducted in 2011-2012 in Québec, Canada, of 567 daily smokers (mean (SD) age 38.3 (8.1); 56.6% female) who lived with children. Poisson regression models with robust variance were used to determine whether single-parent status was independently associated with living in a smoke-free home after accounting for age, sex, language, household size, age of youngest child, neighbourhood material deprivation, socio-economic status and employment status. RESULTS Of 122 participants living in a single-parent family, 33 (27%) reported that their home was smoke-free, compared with 250 of 445 participants (56.2%) living in non-single-parent families. Single parents were approximately 40% less likely to live in smoke-free homes than other daily smokers, even after accounting for indicators of economic disadvantage. CONCLUSIONS Single parents, regardless of income or level of neighbourhood material deprivation, were less likely to report smoke-free home rules. These smokers represent a distinct subgroup that warrants targeted interventions to help them implement such rules by addressing their specific needs against a backdrop of creating more equitable access to the social determinants of health.
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Affiliation(s)
- Annie Montreuil
- Institut national de santé publique du Québec, 190 boul. Crémazie Est, Montréal, Québec, H2P 1E2, Canada. .,Département de psychologie, Université du Québec à Montréal, Montréal, Québec, Canada.
| | - Robert J Wellman
- Department of Population and Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jennifer L O'Loughlin
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Département de médecine sociale et préventive, École de santé publique, Université de Montréal, Montréal, Québec, Canada
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Ruglass LM, Root JC, Dambreville N, Shevorykin A, Haque N, Sun V, Sheffer CE, Melara RD. Smoking policies in the home have less influence on cigarettes per day and nicotine dependence level among African American than White smokers: A cross-sectional analysis. J Natl Med Assoc 2019; 111:606-615. [PMID: 31375277 PMCID: PMC6925645 DOI: 10.1016/j.jnma.2019.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/30/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND African American smokers suffer disproportionately from tobacco-related disease caused, in part, by lower rates of smoking cessation. We examined whether smoke-free home policies and delay discounting were differentially associated with cigarettes smoked per day (CPD) and nicotine dependence (ND) among African Americans and Whites. METHODS Secondary data analysis was conducted using data from 65 African American (n = 40) and White (n = 25) smokers who completed measures of CPD, ND, tobacco craving, stress, depression, home smoking policy, and delay discounting. RESULTS A significant interaction was found between race and home smoking policy on CPD (B = -11.21, p = 0.002) and ND (B = -3.42, p = 0.004). Smoke-free policies in the home were associated with fewer CPD and lower ND levels among Whites, but not among African Americans. Whites who allowed smoking in their homes had significantly greater mean CPD and higher mean ND than their counterparts who did not allow smoking in the home. Among African American smokers, there were no differences in CPD and ND among those who allowed smoking in their home versus those who did not. CONCLUSIONS The findings extend the scientific literature by suggesting that a malleable environmental factor (home smoking policy) commonly associated with cessation among Whites does not have the same influence on cessation among African American.
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Affiliation(s)
- Lesia M Ruglass
- Department of Psychology, The City College of New York, CUNY, USA.
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Naomi Dambreville
- Department of Psychology, The City College of New York and the Graduate Center, CUNY, USA
| | - Alina Shevorykin
- Department of Psychology and Mental Health Counseling, Pace University, USA
| | - Noshin Haque
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Vicki Sun
- Sophie Davis School of Biomedical Education, CUNY School of Medicine, USA
| | | | - Robert D Melara
- Department of Psychology, The City College of New York, CUNY, USA
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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. Am J Public Health 2019; 109:1568-1575. [PMID: 31536405 DOI: 10.2105/ajph.2019.305289] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Tobacco control measures have played an important role in the reduction of the cigarette smoking prevalence among US adults.However, although overall smoking prevalence has declined, it remains high among many subpopulations that are disproportionately burdened by tobacco use, resulting in tobacco-related health disparities. Slow diffusion of smoke-free laws to rural regions, particularly in the South and Southeast, and uneven adoption of voluntary policies in single-family homes and multiunit housing are key policy variables associated with the disproportionate burden of tobacco-related health disparities in these subpopulations.Developing policies that expand the reach of comprehensive smoke-free laws not only will facilitate the decline in smoking prevalence among subpopulations disproportionately burdened by tobacco use but will also decrease exposure to secondhand smoke and further reduce tobacco-caused health disparities in the United States.
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Affiliation(s)
- Amy Y Hafez
- Amy Y. Hafez and Stanton A. Glantz are with the Center for Tobacco Control Research and Education, University of California, San Francisco. Mariaelena Gonzalez is with the School of Social Sciences, Humanities & Arts, University of California, Merced. Margarete C. Kulik is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Maya Vijayaraghavan is with the Zuckerberg San Francisco General Hospital and the Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Mariaelena Gonzalez
- Amy Y. Hafez and Stanton A. Glantz are with the Center for Tobacco Control Research and Education, University of California, San Francisco. Mariaelena Gonzalez is with the School of Social Sciences, Humanities & Arts, University of California, Merced. Margarete C. Kulik is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Maya Vijayaraghavan is with the Zuckerberg San Francisco General Hospital and the Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Margarete C Kulik
- Amy Y. Hafez and Stanton A. Glantz are with the Center for Tobacco Control Research and Education, University of California, San Francisco. Mariaelena Gonzalez is with the School of Social Sciences, Humanities & Arts, University of California, Merced. Margarete C. Kulik is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Maya Vijayaraghavan is with the Zuckerberg San Francisco General Hospital and the Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Maya Vijayaraghavan
- Amy Y. Hafez and Stanton A. Glantz are with the Center for Tobacco Control Research and Education, University of California, San Francisco. Mariaelena Gonzalez is with the School of Social Sciences, Humanities & Arts, University of California, Merced. Margarete C. Kulik is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Maya Vijayaraghavan is with the Zuckerberg San Francisco General Hospital and the Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Stanton A Glantz
- Amy Y. Hafez and Stanton A. Glantz are with the Center for Tobacco Control Research and Education, University of California, San Francisco. Mariaelena Gonzalez is with the School of Social Sciences, Humanities & Arts, University of California, Merced. Margarete C. Kulik is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Maya Vijayaraghavan is with the Zuckerberg San Francisco General Hospital and the Center for Tobacco Control Research and Education, University of California, San Francisco
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Petersen AB, Stewart HC, Walters J, Vijayaraghavan M. Smoking Policy Change Within Permanent Supportive Housing. J Community Health 2019; 43:312-320. [PMID: 28884243 DOI: 10.1007/s10900-017-0423-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Smoke-free policies effectively reduce secondhand smoke (SHS) exposure among non-smokers, and reduce consumption, encourage quit attempts, and minimize relapse to smoking among smokers. Such policies are uncommon in permanent supportive housing (PSH) for formerly homeless individuals. In this study, we collaborated with a PSH provider in San Diego, California to assess a smoke-free policy that restricted indoor smoking. Between August and November 2015, residents completed a pre-policy questionnaire on attitudes toward smoke-free policies and exposure to secondhand smoke, and then 7-9 months after policy implementation residents were re-surveyed. At follow-up, there was a 59.7% reduction in indoor smoking. The proportion of residents who identified as current smokers reduced by 13% (95% CI: -38, 10.2). The proportion of residents who reported never smelling SHS indoors (apartment 24.2%, 95% CI: 4.2, 44.1; shared areas 17.2%, 95% CI: 1.7, 32.7); in outdoor areas next to the living unit (porches or patio 56.7%, 95% CI: 40.7, 72.8); and in other outdoor areas (parking lot 28.6%, 95% CI: 8.3, 48.9) was lower post-policy compared with pre-policy. Overall, resident support increased by 18.7%; however, the greatest increase in support occurred among current smokers (from 14.8 to 37.5%). Fewer current smokers reported that the policy would enable cessation at post-policy compared to pre-policy. Our findings demonstrate the feasibility of implementing smoke-free policies in PSH for formerly homeless adults. However, policy alone appears insufficient to trigger change in smoking behavior, highlighting the need for additional cessation resources to facilitate quitting.
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Affiliation(s)
| | | | - Jon Walters
- Housing Innovation Partners, San Diego, CA, USA
| | - Maya Vijayaraghavan
- Division of General Internal Medicine/Zuckerberg San Francisco General Hospital, School of Medicine, University of California San Francisco, 1001 Potrero Ave, Box 1364, San Francisco, CA, 94110, USA.
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In-Home Secondhand Smoke Exposure Among Urban Children With Asthma: Contrasting Households With and Without Residential Smokers. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 25:E7-E16. [PMID: 29883368 PMCID: PMC6173659 DOI: 10.1097/phh.0000000000000790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Secondhand smoke exposure (SHSe) affects up to half of all children in the United States. Many studies have identified factors associated with in-home SHSe, but few have contrasted these factors between households with and without residential smokers. In the latter case, exposure occurs from only external sources that enter the home, such as visitors or environmental incursion. OBJECTIVE Among children with SHSe at home, to examine demographic and psychosocial differences between households with and without residential smokers. DESIGN Baseline analysis of an observational cohort. SETTING Baltimore City, Maryland. PARTICIPANTS A total of 157 children with asthma, aged 5 to 12 years. MEASURES At-home airborne nicotine, caregiver-reported depression, asthma-related quality of life, functional social support, and demographics. Univariable comparisons were performed between SHS-exposed households with and without residential smokers. Multivariable logistic regression models were fit to examine associations between measured factors and absence of residential smokers. RESULTS Children (78.3%) had at-home SHSe. Of these, 40.7% lived in households without residential smokers. Compared with households with residential smokers, these caregivers endorsed stronger beliefs in SHS harms and also worse functional social support and asthma-related stress, despite no differences in asthma morbidity. In adjusted models, SHS-exposed children with caregivers in the lowest tertile of functional social support (adjusted odds ratio, 3.50; 95% confidence interval, 1.12-10.99), asthma-related quality of life (2.90; 1.06-7.95), and those living alone (5.28; 1.26-22.15) had at least twice higher odds of having exclusively external SHSe than the highest tertile (P trends < .05). CONCLUSIONS In-home SHS exposure remains alarmingly high in urban environments. However, a substantial proportion of this exposure appears to be occurring only from external sources that enter the home. Caregivers in these homes had higher desire but lower agency to avoid SHSe, driven by lack of functional support and physical isolation. Public policies targeting these factors may help remediate exposure in this especially vulnerable population.
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Stillman FA, Tanenbaum E, Wewers ME, Chelluri D, Mumford EA, Groesbeck K, Doogan N, Roberts M. Variations in support for secondhand smoke restrictions across diverse rural regions of the United States. Prev Med 2018; 116:157-165. [PMID: 30261241 PMCID: PMC6689396 DOI: 10.1016/j.ypmed.2018.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/30/2018] [Accepted: 09/22/2018] [Indexed: 10/28/2022]
Abstract
UNLABELLED Significant disparities exist between rural-urban U.S. POPULATIONS Besides higher smoking rates, rural Americans are less likely to be protected from SHS. Few studies focus across all regions, obscuring regional-level differences. This study compares support for SHS restrictions across all HHS regions. DATA 2014/15 TUS-CPS; respondents (n = 228,967): 47,805 were rural residents and 181,162 urban. We examined bi-variates across regions and urban-rural adjusted odds ratios within each. Smoking inside the home was assessed along with attitudes toward smoking in bars, casinos, playgrounds, cars, and cars with kids. Urban respondents were significantly more supportive of all SHS policies: (e.g. smoking in bars [57.9% vs. 51.4%]; support for kids in cars [94.8% vs. 92.5%]. Greatest difference between urban-rural residents was in Mid-Atlantic (bar restrictions) and Southeast (home bans): almost 10% less supportive. Logistic regression confirmed rural residents least likely, overall, to support SHS in homes (OR = 0.78, 95% CI 0.74, 0.81); in cars (OR = 0.87, 95% CI 0.79, 0.95), on playgrounds (OR = 0.88, 95% CI.83, 0.94) and in bars OR = 0.88, 95% CI 0.85, 0.92), when controlling for demographics and smoking status. South Central rural residents were significantly less likely to support SHS policies-home bans, smoking in cars with kids, on playgrounds, in bars and casinos; while Heartland rural residents were significantly more supportive of policies restricting smoking in cars, cars with kids and on playgrounds. Southeast and South Central had lowest policy score with no comprehensive state-level SHS policies. Understanding differences is important to target interventions to reduce exposure to SHS and related health disparities.
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Affiliation(s)
| | - Erin Tanenbaum
- NORC at the University of Chicago, United States of America
| | | | - Devi Chelluri
- NORC at the University of Chicago, United States of America
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Vijayaraghavan M, Benmarnhia T, Pierce JP, White MM, Kempster J, Shi Y, Trinidad DR, Messer K. Income disparities in smoking cessation and the diffusion of smoke-free homes among U.S. smokers: Results from two longitudinal surveys. PLoS One 2018; 13:e0201467. [PMID: 30052671 PMCID: PMC6063424 DOI: 10.1371/journal.pone.0201467] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 07/15/2018] [Indexed: 11/19/2022] Open
Abstract
Background Lower rates of successful quitting among low-income populations in the United States may be from slower dissemination of smoke-free homes, a predictor of cessation. Objectives To explore the role of smoke-free homes in cessation behavior across income levels. Participants Current smokers who were ≥18 years and who participated in the longitudinal 2002–2003 (n = 2801) or 2010–2011 (n = 2723) Tobacco Use Supplements to the Current Population Survey. Measurements We categorized income as multiples of the federal poverty level (FPL) (<300% FPL versus ≥300% FPL). We examined the association of smoke-free homes with 1+day quit attempts and 30+days abstinence at 1-year follow-up. We then conducted a mediation analysis to examine the extent that smoke-free homes contributed to income disparities in 30+days abstinence. Results Between the two surveys, heavy smoking (≥ 1 pack/day) declined by 17%, and smoking prevalence declined by 15% among those with higher-incomes (>300%FPL). Although similar in 2002, the prevalence of smoke-free homes was 33% lower among individuals living <300% FPL than those living ≥300% FPL. Although the quit attempt rate was similar, the 30+days abstinence rate was higher in the 2010–11 cohort than in 2002–3 cohort (20.6% versus 15.5%, p<0.008). Whereas smoking ≥ 1 pack/ day was associated with lower odds of 30+days abstinence (Adjusted odds ratio [AOR] 0.7; 95% CI 0.5–0.9), having a higher income (AOR 1.9, 95% CI 1.4–2.6) and a smoke-free home (AOR 1.6, 95% CI 1.2–2.1) were associated with greater odds of 30+day abstinence. Differential changes in smoke-free homes across income groups between the two surveys contributed to 36% (95% CI 35.7–36.3) of the observed income disparity in 30+days abstinence. Conclusions Increasing the diffusion of smoke-free homes among low-income populations may attenuate at least a third of the income disparities in smoking cessation, highlighting the need for interventions to increase adoption of smoke-free homes among low-income households.
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Affiliation(s)
- Maya Vijayaraghavan
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, United States of America
- * E-mail:
| | - Tarik Benmarnhia
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
- Climate, Atmospheric Science & Physical Oceanography, Scripps Institution of Oceanography, La Jolla, CA, United States of America
| | - John P. Pierce
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Martha M. White
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
| | - Jennie Kempster
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Yuyan Shi
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Dennis R. Trinidad
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Karen Messer
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
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Ha T, Soulakova JN. Survey Mode and Rates of Smoke-free Homes and Support for Smoking Bans Among Single Parents in the United States in 2010-2011 and 2014-2015. ACTA ACUST UNITED AC 2018; 11. [PMID: 29725556 DOI: 10.29115/sp-2018-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
National surveys are commonly used to monitor the rates of smoke-free homes and public attitudes toward smoking bans. The study explored the difference in the estimates corresponding to two survey modes-personal interviews and phone interviews-among single-parent households. Data from the Tobacco Use Supplement to the Current Population Survey administered in 2010-11 and 2014-15 were used in a stratified fashion. The rate of smoke-free homes was lower for personal interviews (79% in 2010-11 and 82% in 2014-15) than for phone interviews (85% in 2010-11 and 90% in 2014-15). Even after controlling for several factors, personal interviews corresponded to lower odds of having a smoke-free home relative to phone interviews (OR=0.7, CI=0.6:0.9 in 2010-11; OR=0.5, CI = 0.4:0.6 in 2014-15). The survey mode should be included in the analyses when estimating the rates of smoke-free homes and other smoking-related attitudes, because different survey modes could be associated with different response bias.
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Affiliation(s)
- Trung Ha
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd., Orlando, FL 32827; 1(407) 266-7072
| | - Julia N Soulakova
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd., Orlando, FL 32827; 1(407) 266-7072
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Mullen PD, Savas LS, Bundy ŁT, Haardörfer R, Hovell M, Fernández ME, Monroy JAA, Williams RS, Kreuter MW, Jobe D, Kegler MC. Minimal intervention delivered by 2-1-1 information and referral specialists promotes smoke-free homes among 2-1-1 callers: a Texas generalisation trial. Tob Control 2018; 25:i10-i18. [PMID: 27697943 PMCID: PMC5099226 DOI: 10.1136/tobaccocontrol-2016-053045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 08/02/2016] [Indexed: 01/15/2023]
Abstract
Background Replication of intervention research is reported infrequently, limiting what we know about external validity and generalisability. The Smoke Free Homes Program, a minimal intervention, increased home smoking bans by United Way 2-1-1 callers in randomised controlled trials in Atlanta, Georgia and North Carolina. Objective Test the programme's generalisability-external validity in a different context. Methods A randomised controlled trial (n=508) of English-speaking callers from smoking-discordant households (≥1 smoker and ≥1 non-smoker). 2-1-1 Texas/United Way HELPLINE call specialists serving the Texas Gulf Coast recruited callers and delivered three mailings and one coaching call, supported by an online tracking system. Data collectors, blind to study assignment, conducted telephone interviews 3 and 6 months postbaseline. Results At 3 months, more intervention households reported a smoke-free home (46.6% vs 25.4%, p<0.0001; growth model intent-to-treat OR=1.48, 95% CI 1.241 to 1.772, p<0.0001). At 6 months, self-reported full bans were 62.9% for intervention participants and 38.4% for controls (OR=2.19). Texas trial participants were predominantly women (83%), single-smoker households (76%) and African-American (65%); half had incomes ≤US$10 000/year (50%). Texas recruitment was <50% of the other sites. Fewer callers reported having a smoker in the household. Almost twice the callers with a household smoker declined interest in the programme/study. Conclusions Our findings in a region with lower smoking rates and more diverse callers, including English-speaking Latinos, support programme generalisability and convey evidence of external validity. Our recruitment experience indicates that site-specific adjustments might improve recruitment efficiency and reach. Trial registration number NCT02097914, Results.
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Affiliation(s)
- Patricia Dolan Mullen
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, Texas, USA
| | - Lara S Savas
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, Texas, USA
| | - Łucja T Bundy
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mel Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Maria E Fernández
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, Texas, USA
| | - Jo Ann A Monroy
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, Texas, USA
| | - Rebecca S Williams
- Center for Health Promotion and Disease Prevention and Lineberger Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Matthew W Kreuter
- Health Communication Research Laboratory, Washington University, St. Louis, Missouri, USA
| | - David Jobe
- 2-1-1 Texas/United Way HELPLINE, United Way of Greater Houston, Houston, Texas, USA
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Outcomes for a Public Hospital Tobacco Cessation Program: The Cook County Health and Hospitals System Experience. J Community Health 2018; 41:1130-1139. [PMID: 27393143 DOI: 10.1007/s10900-016-0215-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study is to determine the rate and predictors of sustained smoking cessation for a cohort of smokers exposed to a guideline-based health education program delivered during routine clinical care at an urban public hospital. This is a retrospective analysis of 755 public hospital system patients who had at least two health educator contacts embedded in routine clinical care, with the latter contact 12-18 months after the baseline. The education occurred during visits to primary care, specialty clinics, urgent/episodic care, or during hospitalization. The assessment of smoking status is determined by the health educators as part of their routine assessment and recorded in the program's database. The primary outcomes are self-reported 12-month sustained smoking cessation at the 12-18 month contact and predictors of cessation. The cohort is predominantly minority smokers (African American 69 % and Latino 15 %) and uninsured (70 %) or on Medicaid (13 %). The sustained cessation rate was 9.3 %. Latino ethnicity, smoking 1-9 cigarettes/day at baseline, reporting smoke-free home, and additional educator contact in the year after the baseline were independent predictors of sustained cessation in the multivariate analysis. Smokers with multiple risks for poor cessation outcomes exposed to a guideline-based program of health education during routine healthcare encounters had sustained smoking cessation rates that compare favorably with published National Health Interview Study population cessation rates. An additional educator contact after the baseline was a predictor of cessation. The findings support development of cessation programs in which health educators are integrated into clinical care settings.
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Butler KM, Rayens MK, Wiggins AT, Rademacher KB, Hahn EJ. Association of Smoking in the Home With Lung Cancer Worry, Perceived Risk, and Synergistic Risk. Oncol Nurs Forum 2018; 44:E55-E63. [PMID: 28222077 DOI: 10.1188/17.onf.e55-e63] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the association of smoking in the home with lung cancer worry, perceived risk, and synergistic risk, controlling for sociodemographics, family history of lung cancer, and health-related self-concept. The hypothesis is that participants with smoking in the home would have higher scores for lung cancer worry, perceived risk, and synergistic risk.
. DESIGN Cross-sectional baseline survey.
. SETTING Participants recruited from an outpatient clinic and pharmacy at University of Kentucky HealthCare, an academic medical center.
. SAMPLE 515 homeowners from a larger randomized, controlled trial aimed at reducing exposure to radon and secondhand smoke (SHS).
. METHODS Homeowners were selected via quota sampling so that about half would have a smoker or smokers in the home.
. MAIN RESEARCH VARIABLES Lung cancer worry and perceived risk; perception of synergistic risk of radon and SHS exposure; demographics.
. FINDINGS Participants with smoking in the home had higher rates of lung cancer worry and perceived risk. In addition, those with less education and a family history of lung cancer and who were current smokers had higher lung cancer worry and perceived lung cancer risk scores. Predictors of perception of synergistic risk were marital status and health-related self-concept.
. CONCLUSIONS Homeowners with smoking in the home, less education, and a family history of lung cancer had greater lung cancer worry and perceived lung cancer risk. Lung cancer risk reduction interventions with vulnerable populations are needed.
. IMPLICATIONS FOR NURSING Nurses are in a unique position to target high-risk populations and identify opportunities to create teachable moments to reduce environmental risks of radon and tobacco smoke exposure.
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Rendón AD, Unger JB, Cruz T, Soto DW, Baezconde-Garbanati L. Perceptions of Secondhand and Thirdhand Smoke Among Hispanic Residents of Multiunit Housing. J Immigr Minor Health 2017; 19:162-169. [PMID: 26545600 DOI: 10.1007/s10903-015-0309-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Despite the progressive adoption of smoking bans in public spaces, children living in multi-unit housing remain at risk of exposure to secondhand smoke (SHS) and thirdhand smoke (THS). Hispanic populations in California are particularly vulnerable to the harmful effects of SHS and THS because a large proportion of Hispanics live in multi-unit housing. Three focus groups were conducted in the fall of 2012 (in Spanish and English, N = 24) to understand Hispanics' knowledge of and experiences with SHS and THS, including barriers to avoiding smoke exposure and strategies for protecting their homes from smoke. Hispanic residents reported unpleasant experiences with SHS and THS and were generally knowledgeable about the adverse health effects, although they were not familiar with the term "thirdhand smoke." Some participants also mentioned marijuana smoke as a potential health hazard. Hispanic cultural values made participants reluctant to confront their neighbors but also motivated them to find ways to protect their families from smoke. Potential solutions included working with the smokers to designate a smoking area and gaining support from the building owners. Broad smoking policies should be implemented to help Hispanic residents overcome cultural and social barriers to smoke free air.
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Affiliation(s)
- Angélica Delgado Rendón
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Ave., Los Angeles, CA, 90034, USA
| | - Jennifer B Unger
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Ave., Los Angeles, CA, 90034, USA.
| | - Tess Cruz
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Ave., Los Angeles, CA, 90034, USA
| | - Daniel W Soto
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Ave., Los Angeles, CA, 90034, USA
| | - Lourdes Baezconde-Garbanati
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Ave., Los Angeles, CA, 90034, USA
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Smoke-free homes among single-parent families: Differences associated with parental race/ethnicity and smoking behaviors. Prev Med Rep 2017; 9:18-23. [PMID: 29255668 PMCID: PMC5726876 DOI: 10.1016/j.pmedr.2017.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/05/2017] [Indexed: 11/23/2022] Open
Abstract
We assessed differences in the rates of smoke-free homes among single-parent households with regard to parental race/ethnicity and smoking status. We identified two cohorts representative of the U.S. single-parent households with underage children (children under the age of 18) based on the Tobacco Use Supplement to the Current Population Survey: 2010-11 (n = 6474) and 2014-15 (n = 6114). The interviews were conducted by phone and in-person. Statistical analysis was performed in 2017. The overall rate of smoke-free homes was 82% in 2010-11 and 86% in 2014-15. The rate of a smoke-free home was highest for Non-Hispanic (NH) Asian (94%) and Hispanic (92%) parents and lowest for NH Multiracial (77% in 2010-11 and 82% in 2014-15) in both survey periods. However, 2014-15 model-based comparisons relative to NH Whites indicated only one significant difference: the rate was lower for NH Blacks (OR = 0.46, 99% CI = 0.32:0.66). The smoke-free homes were least prevalent among daily smokers, followed by occasional smokers, followed by former smokers, and most prevalent among never smokers in each survey period. The 2010-11 and 2014-15 rates were 45% and 54% for daily, 64% and 72% for occasional, 89% and 91% for former, and 93% and 94% for never smokers. The gap in the rates of smoke-free homes for diverse parental racial/ethnic groups observed in 2010-11 decreased by 2014-15. While smoke-free homes became more prevalent in 2014-15, the rates remain drastically different among families with different parental smoking behaviors. Exposure to secondhand smoke at home remains common among single-parent households where the parent smokes.
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Milcarz K, Bak-Romaniszyn L, Kaleta D. Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E447. [PMID: 28430128 PMCID: PMC5409647 DOI: 10.3390/ijerph14040447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/05/2017] [Accepted: 04/19/2017] [Indexed: 11/17/2022]
Abstract
This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the "Reducing Social Inequalities in Health" program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes-a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS.
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Affiliation(s)
- Katarzyna Milcarz
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, 90-752 Lodz, Poland.
| | - Leokadia Bak-Romaniszyn
- Department of Nutrition in Digestive Tract Diseases, Medical University of Lodz, 93-338 Lodz, Poland.
| | - Dorota Kaleta
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, 90-752 Lodz, Poland.
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24
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Steinberg ML, Stahl NF, Williams JM. Household Smoking Restrictions Relate To Time To First Cigarette Smoked In The Morning. J Smok Cessat 2017; 12:1-5. [PMID: 38572325 PMCID: PMC10989735 DOI: 10.1017/jsc.2015.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction The time a smoker waits until the first cigarette of the morning is often used as a measure of dependence with the rationale that more dependent smokers will smoke sooner upon waking than will less dependent smokers after going several hours without a cigarette overnight. Aims We sought to examine the relationship between time-to-first-cigarette (TTFC) and household smoking restrictions in two independent samples. Methods Two samples of smokers, one treatment-seeking community sample (N = 433) and one non-treatment-seeking sample of smokers with serious mental illness (i.e., Schizophrenia, Schizoaffective Disorder, or Bipolar I Disorder) (N = 94), provided information on cigarette dependence with the Fagerström Test for Nicotine Dependence and on household smoking restrictions. Results Half (50%) of smokers with serious mental illness and 36.7% of smokers from the general population reported that there were no limitations to smoking in their home. Household smoking restrictions were significantly and positively related to TTFC in both samples. Conclusions These data indicate that greater attention to TTFC may be warranted. The TTFC item is intended to measure dependence based on the premise that greater dependence should be associated with shorter TTFC. If TTFC is related to a household smoking ban, however, this item may not be assessing dependence as intended in some cases.
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Affiliation(s)
- Marc L Steinberg
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Naomi F Stahl
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Jill M Williams
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Williams RS, Stollings JH, Bundy Ł, Haardörfer R, Kreuter MW, Mullen PD, Hovell M, Morris M, Kegler MC. A Minimal Intervention to Promote Smoke-Free Homes among 2-1-1 Callers: North Carolina Randomized Effectiveness Trial. PLoS One 2016; 11:e0165086. [PMID: 27806060 PMCID: PMC5091897 DOI: 10.1371/journal.pone.0165086] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 10/04/2016] [Indexed: 11/23/2022] Open
Abstract
This study examined the extent to which delivery of the minimal Smoke-Free Homes intervention by trained 2-1-1 information and referral specialists had an effect on the adoption of home smoking bans in low-income households. A randomized controlled trial was conducted among 2-1-1 callers (n = 500) assigned to control or intervention conditions. 2-1-1 information and referral specialists collected baseline data and delivered the intervention consisting of 3 mailings and 1 coaching call; university-based data collectors conducted follow-up interviews at 3 and 6 months post-baseline. Data were collected from June 2013 through July 2014. Participants were mostly female (87.2%), African American (61.4%), and smokers (76.6%). Participants assigned to the intervention condition were more likely than controls to report a full ban on smoking in the home at both 3- (38.1% vs 19.3%, p = < .001) and 6-month follow-up (43.2% vs 33.2%, p = .02). The longitudinal intent-to-treat analysis showed a significant intervention effect over time (OR = 1.31, p = .001), i.e. OR = 1.72 at 6 months. This study replicates prior findings showing the effectiveness of the minimal intervention to promote smoke-free homes in low-income households, and extends those findings by demonstrating they can be achieved when 2-1-1 information and referral specialists deliver the intervention. Findings offer support for this intervention as a generalizable and scalable model for reducing secondhand smoke exposure in homes.
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Affiliation(s)
- Rebecca S. Williams
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, United States of America
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, United States of America
- * E-mail:
| | - Jana H. Stollings
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, United States of America
| | - Łucja Bundy
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Matthew W. Kreuter
- Health Communication Research Laboratory, Washington University, St. Louis, Missouri, United States of America
| | - Patricia Dolan Mullen
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, Texas, United States of America
| | - Mel Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, California, United States of America
| | - Marti Morris
- United Way of North Carolina, NC 2-1-1, Cary, North Carolina, United States of America
| | - Michelle C. Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Simmons VN, Pineiro B, Hooper MW, Gray JE, Brandon TH. Tobacco-Related Health Disparities Across the Cancer Care Continuum. Cancer Control 2016; 23:434-441. [PMID: 27842333 PMCID: PMC5972388 DOI: 10.1177/107327481602300415] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Use of tobacco is the leading preventable cause of death in the United States. Racial/ethnic minorities and individuals of low socioeconomic status disproportionately experience tobacco-related disease and illness. Unique challenges and circumstances exist at each point in the cancer care continuum that may contribute to the greater cancer burden experienced by these groups. METHODS We reviewed tobacco-related disparities from cancer prevention to cancer survivorship. We also describe research that seeks to reduce tobacco-related disparities. RESULTS Racial/ethnic minorities and low-income individuals experience unique social and environmental contextual challenges such as greater environmental cues to smoke and greater levels of perceived stress and social discrimination. Clinical practice guidelines support the effectiveness of pharmacotherapy and behavioral counseling for racial and ethnic minorities, yet smoking cessation rates are lower in this group when compared with non-Hispanic whites. Superior efficacy for culturally adapted interventions has not yet been established. CONCLUSIONS To reduce health disparities in this population, a comprehensive strategy is needed with efforts directed at each point along the cancer care continuum. Strategies are needed to reduce the impact of contextual factors such as targeted tobacco marketing and social discrimination on smoking initiation and maintenance. Future efforts should focus on increasing the use of evidence-based cessation treatment methods and studying its effectiveness in these populations. Attention must also be focused on improving treatment outcomes by reducing smoking in diverse racial and ethnic patient populations.
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Affiliation(s)
- Vani Nath Simmons
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
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Vijayaraghavan M, Schroeder SA, Kushel M. The effectiveness of tobacco control policies on vulnerable populations in the USA: a review. Postgrad Med J 2016; 92:670-676. [DOI: 10.1136/postgradmedj-2014-133193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/24/2016] [Accepted: 08/27/2016] [Indexed: 11/04/2022]
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Hoehn JL, Riekert KA, Borrelli B, Rand CS, Eakin MN. Barriers and motivators to reducing secondhand smoke exposure in African American families of head start children: a qualitative study. HEALTH EDUCATION RESEARCH 2016; 31:450-64. [PMID: 27329373 PMCID: PMC4945858 DOI: 10.1093/her/cyw028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 05/20/2016] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To identify barriers and motivators for reducing secondhand smoke exposure (SHSe) for families of African-American, low-income, urban children. METHOD Audiotaped intervention sessions of 52 African-American caregivers of Head Start children who reported being a smoker and/or had at least one smoker in the home were randomly sampled from a larger trial examining the effectiveness of a motivational-interviewing intervention in reducing child's SHSe. Counseling sessions were qualitatively coded to identify barriers and motivators to implementing a home smoking ban or quitting smoking. RESULTS African-American families identified several themes that were either or both barriers and motivators for SHSe reduction, including: asking others not to smoke, other family living in the home, neighborhood safety, absence of childcare, cost/availability of cessation tools, physician support and prevention of health problems. DISCUSSION Urban, low-income African-American families face numerous barriers to reducing SHSe. Families were able to identify many motivators for reducing SHSe, suggesting an awareness of the importance for SHSe reduction but uncertainty in their confidence to change behaviors. Counseling should include tailoring to be most effective in supporting health behavior change. Greater emphasis on motivators is needed, such as low-cost/free cessation tools, engagement from physicians and greater involvement of extended family members.
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Affiliation(s)
- Jessica L Hoehn
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, 21250, USA
| | - Kristin A Riekert
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21224, USA
| | - Belinda Borrelli
- Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, 02118, USA
| | - Cynthia S Rand
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21224, USA
| | - Michelle N Eakin
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21224, USA
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Welkom JS, Riekert KA, Rand CS, Eakin MN. Associations Between Caregiver Health Literacy and Preschool Children's Secondhand Smoke Exposure. J Pediatr Psychol 2016; 41:462-72. [PMID: 26330535 PMCID: PMC5009453 DOI: 10.1093/jpepsy/jsv077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 07/21/2015] [Accepted: 07/24/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Examine the associations between caregiver health literacy (HL) and smoking-related outcome expectancies, implementation of home/car smoking bans (H/CSBs), and child secondhand smoke exposure (SHSe). METHODS Caregivers of Head Start children residing with a smoker(s) completed measures assessing HL, outcome expectancies, and H/CSB implementation. Biomarkers of child SHSe included home air nicotine monitors and child salivary cotinine. RESULTS Caregivers with lower HL had higher levels of home air nicotine and child salivary cotinine in the full sample and among smokers. After controlling for child age and number of smokers in the home, lower HL was associated with higher endorsement of negative smoking expectancies in the full sample and in smokers. HL was not associated with H/CSB implementation across groups. CONCLUSIONS Caregiver HL is associated with child SHSe and is important in shaping smoking-related beliefs. HL is not directly related to adoption of SHSe-reduction behaviors such as H/CSBs.
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Affiliation(s)
- Josie S Welkom
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine
| | - Kristin A Riekert
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine
| | - Cynthia S Rand
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine
| | - Michelle N Eakin
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine
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Yao T, Sung HY, Wang Y, Lightwood J, Max W. Sociodemographic Differences Among U.S. Children and Adults Exposed to Secondhand Smoke at Home: National Health Interview Surveys 2000 and 2010. Public Health Rep 2016; 131:357-66. [PMID: 26957671 PMCID: PMC4765985 DOI: 10.1177/003335491613100220] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We examined the levels and change in prevalence of self-reported secondhand smoke (SHS) exposure at home, and analyzed sociodemographic differences in exposure among children (aged 0-17 years) and nonsmoking adults (aged ≥18 years) in the United States in 2000 and 2010. METHODS We included 18,731 children and 44,049 adults from the 2000 and 2010 National Health Interview Survey Cancer Control Supplements. We used multivariate logistic regression to determine the factors associated with exposure. RESULTS The prevalence of self-reported SHS exposure declined from 2,627 of 10,636 (24.7%) to 663 of 8,095 (8.2%) for children and from 2,863 of 23,665 (12.1%) to 897 of 20,384 (4.4%) for adults from 2000 to 2010. SHS exposure declined for all population subgroups between the two years, but differences were found. Compared with 2000, children aged 12-17 years in 2010 were no longer more likely than children aged 0-5 years to be exposed to SHS. Non-Hispanic black children and adults were more likely than non-Hispanic white children and adults to be exposed to SHS in 2010. In 2010, no differences were found for children whose parents had a higher level of education, and no differences were observed for children or adults with high family income vs. other levels of family income. Children living in the Midwest and South had higher levels of SHS exposure than children in other regions in 2010. CONCLUSIONS Self-reported SHS exposure at home declined for all population subgroups from 2000 to 2010, but socioeconomic differences existed for some subgroups in both years. Current tobacco control policies need to be improved to reach all population subgroups so that SHS exposure can be further reduced, especially among vulnerable populations.
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Affiliation(s)
- Tingting Yao
- University of California, San Francisco, Institute for Health & Aging, San Francisco, California
| | - Hai-Yen Sung
- University of California, San Francisco, Institute for Health & Aging, San Francisco, California
| | - Yingning Wang
- University of California, San Francisco, Institute for Health & Aging, San Francisco, California
| | - James Lightwood
- University of California, San Francisco, School of Pharmacy, Department of Clinical Pharmacy, San Francisco, California
| | - Wendy Max
- University of California, San Francisco, Institute for Health & Aging, San Francisco, California
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Kegler MC, Haardörfer R, Bundy LT, Escoffery C, Berg CJ, Fernandez M, Williams R, Hovell M. Do partial home smoking bans signal progress toward a smoke-free home? HEALTH EDUCATION RESEARCH 2016; 31:24-35. [PMID: 26661723 PMCID: PMC4883035 DOI: 10.1093/her/cyv066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 11/06/2015] [Indexed: 06/05/2023]
Abstract
Understanding who establishes partial home smoking bans, what these bans cover, and whether they are an intermediate step in going smoke-free would help to inform smoke-free home interventions. Participants were recruited from United Way of Greater Atlanta's 2-1-1 contact center. Data were collected at baseline, 3 and 6 months via telephone interview. Participants (n = 375) were mostly African American (84.2%) and female (84.3%). The majority (58.5%) had annual household incomes <$10,000. At baseline, 61.3% reported a partial smoking ban and 38.7% reported no ban. Existence of a partial ban as compared with no ban was associated with being female, having more than a high school education, being married and younger age. Partial bans most often meant smoking was allowed only in designated rooms (52.6%). Other common rules included: no smoking in the presence of children (18.4%) and smoking allowed only in combination with actions such as opening a window or running a fan (9.8%). A higher percentage of households with partial bans at baseline were smoke-free at 6 months (36.5%) compared with households with no bans at baseline (22.1%). Households with partial smoking bans may have a higher level of readiness to go smoke-free than households with no restrictions.
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Affiliation(s)
- Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322,
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Lucja T Bundy
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Maria Fernandez
- School of Public Health, University of Texas Health Sciences Center, Houston, TX 77030
| | - Rebecca Williams
- Gillings School of Global Public Health, Chapel Hill, University of North Carolina, Chapel Hill, NC 27510 and
| | - Mel Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA 91941, USA
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Petersen AB, Tsoh JY, Nguyen TT, McPhee SJ, Burke NJ. Suffering in Silence: Impact of Tobacco Use on Communication Dynamics Within Vietnamese and Chinese Immigrant Families. JOURNAL OF FAMILY NURSING 2016; 22:108-132. [PMID: 26717960 PMCID: PMC5714689 DOI: 10.1177/1074840715618194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal of this project was to explore family communication dynamics and their implications for smoking cessation. We conducted 39 in-depth dyadic and individual qualitative interviews with 13 immigrant smoker-family member pairs of Vietnamese ( n = 9 dyads, 18 individuals) and Chinese ( n = 4 dyads, 8 individuals) descent, including seven current and six former smokers and 13 family members. All 13 dyadic and 26 individual interviews were analyzed using a collaborative crystallization process as well as grounded theory methods. We identified three interrelated pathways by which tobacco use in immigrant Vietnamese and Chinese families impacts family processes and communication dynamics. Using a two-dimensional model, we illustrate how the shared consequences of these pathways can contribute to a dynamic of avoidance and noncommunication, resulting in individual family members "suffering in silence" and ultimately smoking being reinforced. We discuss the implications of these findings for development of smoking cessation interventions.
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Affiliation(s)
- Anne Berit Petersen
- 1 University of California, San Francisco, CA, USA
- 2 Loma Linda University, CA, USA
| | | | | | | | - Nancy J Burke
- 1 University of California, San Francisco, CA, USA
- 3 University of California, Merced, CA, USA
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National and state prevalence of smoke-free rules in homes with and without children and smokers: Two decades of progress. Prev Med 2016; 82:51-8. [PMID: 26601642 PMCID: PMC4766981 DOI: 10.1016/j.ypmed.2015.11.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/28/2015] [Accepted: 11/09/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The home is the primary source of secondhand smoke (SHS) exposure for children. We assessed national and state progress in smoke-free home (SFH) rule adoption in homes with and without children and adult smokers. METHODS Data came from the 1992-1993 and 2010-2011 Tobacco Use Supplements to the Current Population Survey, a U.S. national probability household survey. Households were defined as having a SFH rule if all household respondents aged ≥18 indicated no one was allowed to smoke inside the home at any time. Households with children were those with occupants aged <18. Smokers were those who smoked ≥100 lifetime cigarettes and now smoked "everyday" or "some days". RESULTS From 1992-1993 to 2010-2011, SFH rule prevalence increased from 43.0% to 83.0% (p<.05). Among households with children, SFH rules increased overall (44.9% to 88.6%), in households without smokers (59.7% to 95.0%), and households with ≥1 smokers (9.7% to 61.0%) (p<.05). Among households without children, SFH rules increased overall (40.8% to 81.1%), in households without smokers (53.4% to 90.1%), and households with ≥1 smokers (6.3% to 40.9%) (p<.05). Prevalence increased in all states, irrespective of smoker or child occupancy (p<.05). In 2010-2011, among homes with smokers and children, SFH rule prevalence ranged from 36.5% (West Virginia) to 86.8% (California). CONCLUSIONS Considerable progress has been made adopting SFH rules, but many U.S. children continue to be exposed to SHS because their homes are not smoke-free. Further efforts to promote adoption of SFH rules are essential to protect all children from this health risk.
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Jung SJ, Shin A, Kang D. Active smoking and exposure to secondhand smoke and their relationship to depressive symptoms in the Korea national health and nutrition examination survey (KNHANES). BMC Public Health 2015; 15:1053. [PMID: 26468075 PMCID: PMC4606499 DOI: 10.1186/s12889-015-2402-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 10/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between tobacco smoking, including secondhand smoking, and depression has been assessed. The purpose of this study was to evaluate the association between secondhand smoking among current, former and never smokers and depressive symptoms. For secondhand smoking, gender differences and sources of exposure were examined. METHODS Data from 34,693 participants from the fourth and fifth Korean Health and Nutritional Examination Survey (2007-2012) were analyzed in 2014. Self-reported exposure to active (current, former or never) and secondhand smoking and depressive symptoms experienced during the past year were analyzed using logistic regression. The dose-response relationship between duration of secondhand smoke exposure and depression was assessed with stratification by gender and sources of exposure (at home only, at the workplace only or both). RESULTS Regardless of their smoking status, all women who had secondhand smoke exposure at home reported more depressive symptoms than non-smoking women without any exposure to secondhand cigarette smoking (OR 1.43, 95 % CI 1.04-1.96 for current smokers; OR 2.32, 95 % CI 1.04-5.16 for former smokers; OR 1.25, 95 % CI 1.08-1.43 for never smokers). There was also a significant dose-response pattern (p-trend <0.001) for the duration of secondhand smoke exposure at home among women. No significant association was found between smoking and depressive symptoms in men. CONCLUSIONS There was a significant association between secondhand smoke exposure at home and depressive symptoms in women. Secondhand smoke exposure at home was associated with depressive symptoms in a dose-response manner.
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Affiliation(s)
- Sun Jae Jung
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea.
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
| | - Daehee Kang
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea.
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
- Cancer Research Institute, Seoul National University Hospital, Seoul, South Korea.
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Banerjee SC, Ostroff JS, Bari S, D'Agostino TA, Khera M, Acharya S, Gany F. Gutka and Tambaku Paan use among South Asian immigrants: a focus group study. J Immigr Minor Health 2015; 16:531-9. [PMID: 23579964 DOI: 10.1007/s10903-013-9826-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Smokeless tobacco use is prevalent among South Asian immigrants, particularly in the forms of gutka and tambaku paan. In this paper, we examined (a) gutka and tambaku paan initiation and use patterns among South Asian immigrants, and (b) perceptions related to quitting and tobacco control. Six focus groups were conducted with 39 South Asian adult gutka/tambaku paan users, in three different South Asian languages (Gujarati, Bengali, and Urdu). Participants reported easy availability of gutka and tambaku paan in neighborhood stores, and noted several factors that promoted initiation (including social networks, perceived benefits, and curiosity). Due to awareness of low social acceptance of gutka and tambaku paan in the US, some participants discussed changing patterns of use following immigration. Finally, participants proposed roles of various agencies (e.g., doctors'/dentists' role, government-led initiatives) for tobacco control in South Asian immigrant communities. This research provides implications for improving tobacco control efforts in the United States, particularly for South Asian immigrants.
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Affiliation(s)
- Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th floor, New York, NY, 10022, USA,
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Kegler MC, Haardӧrfer R, Berg C, Escoffery C, Bundy L, Williams R, Mullen PD. Challenges in Enforcing Home Smoking Rules in a Low-Income Population: Implications for Measurement and Intervention Design. Nicotine Tob Res 2015; 18:976-81. [PMID: 26246049 DOI: 10.1093/ntr/ntv165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 07/23/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smoke-free homes reduce exposure to secondhand smoke, contribute to lower levels of consumption, and help smokers to quit. Even when home smoking rules are established however, they may not be consistently enforced. METHODS This study uses data from a randomized controlled trial of a brief intervention to create smoke-free homes among callers to the United Way of Greater Atlanta 2-1-1. Participants with partial or full home smoking bans at 6-month follow-up were asked about enforcement challenges, rooms where smoking occurred, and exceptions to the rules. Air nicotine monitors were placed in a subset of homes. RESULTS Participants (n = 286) were mostly female (84.6%) and African American (84.9%). Most were smokers (79.0%) and reported at least half of their friends and relatives smoked (63.3%). Among those with a full ban, 4.3% reported their rules were broken very often whereas 52.6% stated they were never broken. Bad weather and parties were the most common exceptions to rules. Among nonsmokers with full bans, 16% reported exposure to secondhand smoke in the home 1-3 days in the past week. In multivariate analyses, having a partial ban, being a nonsmoker, and living with three or more smokers predicted higher levels of enforcement challenges. CONCLUSIONS Findings suggest the majority of households with newly adopted smoke-free rules had no or rare enforcement challenges, but about one-fifth reported their rules were broken sometimes or very often. Interventions to create smoke-free homes should address enforcement challenges as newly adopted rules may be fragile in some households. IMPLICATIONS Interventions that promote smoke-free homes should address enforcement challenges.
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Affiliation(s)
- Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA;
| | - Regine Haardӧrfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Carla Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Lucja Bundy
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Rebecca Williams
- Cancer Prevention and Control Research Network, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Patricia Dolan Mullen
- Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX
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Gorini G, Carreras G, Cortini B, Verdi S, Petronio MG, Sestini P, Chellini E. Impact of National Smoke-Free Legislation on Educational Disparities in Smoke-Free Homes: Findings from the SIDRIAT Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015. [PMID: 26213956 PMCID: PMC4555243 DOI: 10.3390/ijerph120808705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Families with lower socioeconomic status are less likely to adopt household smoking bans (HSB). The aim of this study was to determine whether socioeconomic disparities in HSB prevalence in Italy decreased 7–9 years after the introduction of the Italian ban on smoking in public places. A longitudinal, 12-year, two-wave study was conducted on a sample of 3091 youths aged 6–14 years in 2002; 1763 (57%) were re-interviewed in 2012–2014. A Poisson regression with a robust error variance was used to assess the association between socioeconomic disparities and HSB prevalence. The adoption of HSBs significantly increased from 60% in 2002 to 75% in 2012–2014, with the increase recorded in youths with ≥1 smoking parent only (from 22% at baseline to 46% at follow-up). The presence of HSBs at baseline was more likely in families with ≥1 graduate parent compared to those with no graduate parents (prevalence ratio (PR) = 1.34, 95% confidence interval (CI) = 1.15–1.57), either in families with ≥1 smoking parent (PR = 1.36, 95% CI = 1.17–1.58) or in families with non-smoking parents (PR = 1.61, 95% CI = 1.01–2.56). Conversely, at follow-up socioeconomic disparities dropped since families with no graduate parents were 1.5-fold more likely to introduce a HSB between the two waves. The Italian ban on smoking in public places may have increased the adoption of smoke-free homes in families with smoking and non-graduate parents, causing the drop of the socioeconomic gap in smoke-free homes.
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Affiliation(s)
- Giuseppe Gorini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence 50141, Italy.
| | - Giulia Carreras
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence 50141, Italy.
| | - Barbara Cortini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence 50141, Italy.
| | - Simona Verdi
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence 50141, Italy.
| | | | - Piersante Sestini
- Section of Phthisiology and Diseases of Respiratory Tract, Siena University, Siena 53100, Italy.
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence 50141, Italy.
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Luh DL, Chen HH, Yen AMF, Wang TT, Chiu SYH, Fann CY, Chen SLS. Effect of self-reported home smoking restriction on smoking initiation among adolescents in Taiwan: a prospective cohort study. BMJ Open 2015; 5:e007025. [PMID: 26116613 PMCID: PMC4486945 DOI: 10.1136/bmjopen-2014-007025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aims of this study were to investigate the influence of home smoking restriction (HSR) and the modified effect of parental smoking on smoking initiation among adolescents. DESIGN Prospective Cohort Study. SETTING Junior high school in Keelung City, Taiwan. PARTICIPANTS This study collected and evaluated primary data from the Adolescent Smoking and Other Health-Related Behaviour Survey conducted in Keelung City, which aimed to investigate smoking and health-related behaviours in junior high school students (2008-2009). Data on students free of smoking in 2008 and following them until 2009 (n=901) to ascertain whether they had started smoking were analysed with logistic regression mode to examine the proposed postulates. MAIN OUTCOME MEASURE The outcome variable was smoking initiation, which was defined as smoking status (yes/no) in the 2009 follow-up questionnaire. The main independent variable was HSR obtained from an adolescent self-reported questionnaire. Information on parental smoking was measured by adolescents self-reporting the smoking behaviour of their father and mother. RESULTS The rate of HSR was 29.79% among 7th grade adolescents. The effect of HSR on smoking initiation in adolescents was statistically significantly modified by paternal smoking (p=0.04) but not by maternal smoking (p=0.54). The effect of HSR on smoking initiation was small for fathers with the habit of smoking (OR=0.89, 95% CI (0.42 to 1.88)), but the corresponding effect size was 3.2-fold (OR=2.84, 95% CI 1.19 to 6.81) for fathers without the habit of smoking. CONCLUSIONS Paternal smoking behaviour may play an interactive role with HSR in preventing smoking initiation among Taiwanese adolescents.
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Affiliation(s)
- Dih-Ling Luh
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsiu-Hsi Chen
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ting-Ting Wang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department and Graduate Institute of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Yuan Fann
- Department of Health Industry Management, School of Healthcare Management, Kainan University, Taoyuan, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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Zhang X, Martinez-Donate A, Rhoads N. Parental Practices and Attitudes Related to Smoke-Free Rules in Homes, Cars, and Outdoor Playgrounds in US Households With Underage Children and Smokers, 2010-2011. Prev Chronic Dis 2015; 12:E96. [PMID: 26086609 PMCID: PMC4473600 DOI: 10.5888/pcd12.140553] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction A smoke-free environment protects children from exposure to involuntary smoke and also can reduce or prevent future smoking behavior. The purpose of this study was to examine levels and correlates of parental behavior and attitudes related to voluntary smoke-free rules in homes, cars, and outdoor children’s play areas among US households with underage children and 1 or more smoking parents. Methods We used data from the 2010–2011 Tobacco Use Supplement to the Current Population Survey and logistic regressions to model behavior and attitudes related to voluntary smoke-free rules in 3 settings. Results Overall, 60.1% of households with children and at least 1 smoking parent had voluntary smoke-free home rules. Approximately 84.6% and 71.5% of parents thought that smoking should not be allowed inside cars with children present and in outdoor play areas, respectively. Positive parental behavior and attitudes related to voluntary smoke-free rules were more likely among households with 2 parents, parents of higher education and household income, Hispanic parents, and parents of infants (P < .05). Conclusion Tobacco control and prevention efforts are needed to promote the voluntary adoption of smoke-free rules in homes, private cars, and outdoor children’s play areas. Most parents from smoker households with underage children were supportive of smoke-free laws for cars and outdoor children’s play areas, providing evidence and encouragement to policy makers to take action to restrict smoking in these locations.
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Affiliation(s)
- Xiao Zhang
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ana Martinez-Donate
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 N. Walnut St, Madison, WI 53726.
| | - Natalie Rhoads
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
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Kegler MC, Bundy L, Haardörfer R, Escoffery C, Berg C, Yembra D, Kreuter M, Hovell M, Williams R, Mullen PD, Ribisl K, Burnham D. A minimal intervention to promote smoke-free homes among 2-1-1 callers: a randomized controlled trial. Am J Public Health 2015; 105:530-7. [PMID: 25602863 DOI: 10.2105/ajph.2014.302260] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We tested the efficacy of a minimal intervention to create smoke-free homes in low-income households recruited through the United Way of Greater Atlanta 2-1-1, an information and referral system that connects callers to local social services. METHODS We conducted a randomized controlled trial (n=498) from June 2012 through June 2013, with follow-up at 3 and 6 months. The intervention consisted of 3 mailings and 1 coaching call. RESULTS Participants were mostly smokers (79.7%), women (82.7%), African American (83.3%), and not employed (76.5%), with an annual household income of $10,000 or less (55.6%). At 6-months postbaseline, significantly more intervention participants reported a full ban on smoking in the home than did control participants (40.0% vs 25.4%; P=.002). The intervention worked for smokers and nonsmokers, as well as those with or without children. CONCLUSIONS Minimal intervention was effective in promoting smoke-free homes in low income households and offers a potentially scalable model for protecting children and adult nonsmokers from secondhand smoke exposure in their homes.
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Affiliation(s)
- Michelle C Kegler
- Michelle C. Kegler, Regine Haardörfer, Cam Escoffery, and Carla Berg are with the Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA. Lucja Bundy and Debbie Yembra are with the Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta. Matthew Kreuter is with the George Warren Brown School of Social Work, Washington University, St. Louis, MO. Mel Hovell is with the Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, CA. Rebecca Williams is with the Gillings School of Global Public Health, Chapel Hill, NC. Patricia Dolan Mullen is with the School of Public Health, University of Texas Health Sciences Center, Houston. Kurt Ribisl is with the Department of Health Behavior, Gillings School of Global Public Health, Chapel Hill. Donna Burnham is with the United Way of Greater Atlanta, GA
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Environmental tobacco smoke exposure among smokers and non-smokers receiving outpatient substance abuse treatment. Addict Behav 2014; 39:1718-22. [PMID: 25117848 DOI: 10.1016/j.addbeh.2014.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 06/17/2014] [Accepted: 07/10/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Environmental Tobacco Smoke (ETS) has been linked to numerous health problems. While research has demonstrated high prevalence of tobacco use among individuals receiving treatment for substance use disorders (SUDs), no studies have examined ETS among individuals receiving treatment for SUDs, paying specific attention to non-smokers who may be at risk for high exposure to ETS. METHODS Participants (N=261) enrolled in outpatient substance abuse treatment completed a survey, in which 14 items were used to quantify ETS exposure and smoking policies across several environments. RESULTS Among smokers, 85% reported that their significant others also smoked as compared to 15% among non-smokers (χ(2)=6.624, p<.05). A logistic regression examined the characteristics that predicted smoking in the home. The overall model was significant, (χ(2)=36.046, p<.0005) with variables that independently predicted smoking in the home included having less than a high school diploma, being female, and living with a smoker. Income, age, and living with children were not found to be significant. Overall, 42% white collar workers 26% of service workers and 30% of blue collar workers reported no exposure to ETS. Sixty-seven percent of smokers strongly agreed or agreed that the hazards of secondhand smoke have been clearly demonstrated versus 58% of non-smokers. CONCLUSIONS Smokers and non-smokers enrolled in outpatient substance abuse treatment are frequently exposed to ETS at home, work, and in social settings. The dangers of ETS should be addressed among this population through education, smoke-free policies, and cessation resources, with help from their treatment facility.
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Zheng P, Berg CJ, Kegler MC, Fu W, Wang J, Zhou X, Liu D, Fu H. Smoke-free homes and home exposure to secondhand smoke in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:12015-28. [PMID: 25419875 PMCID: PMC4245657 DOI: 10.3390/ijerph111112015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/05/2014] [Accepted: 11/10/2014] [Indexed: 11/27/2022]
Abstract
Few studies have examined home exposure to secondhand smoke (SHS) in China. This study aimed to document: (1) the prevalence and correlates of exposure to SHS in homes (in adult non-smokers) in Shanghai, and (2) enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8%) participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors.
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Affiliation(s)
- Pinpin Zheng
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Carla J Berg
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Michelle C Kegler
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Wenjie Fu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Jing Wang
- Center of Disease Control, Pudong District, Shanghai 200136, China.
| | - Xilan Zhou
- Center of Disease Control, Pudong District, Shanghai 200136, China.
| | - Dong Liu
- Center of Disease Control, Fengxian District, Shanghai 201400, China.
| | - Hua Fu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Nicholson JS, McDermott MJ, Huang Q, Zhang H, Tyc VL. Full and home smoking ban adoption after a randomized controlled trial targeting secondhand smoke exposure reduction. Nicotine Tob Res 2014; 17:612-6. [PMID: 25324431 DOI: 10.1093/ntr/ntu201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 09/22/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The current study examined home and full (i.e., home plus car) smoking ban adoption as secondary outcomes to a randomized controlled trial targeting reduced secondhand smoke exposure (SHSe) for children under treatment for cancer. METHODS Families with at least 1 adult smoker who reported SHSe for their children (n = 119) were randomized to control or intervention conditions and followed for 1 year with 5 assessments. Both groups were advised of the negative health outcomes associated with SHSe; the intervention group provided more in-depth counseling from baseline to 3 months. Parents reported on household and car smoking behavior, demographic, psychosocial, and medical/treatment-related information. RESULTS Regardless of group assignment, there was an increase in home (odds ration [OR] = 1.16, p = .074) and full (OR = 1.37, p = .001) smoking ban adoption across time. Families in the intervention group were more likely to adopt a full ban by 3 months, but this difference was nonsignificant by 12 months. Married parents (OR = 2.33, p = .006) and those with higher self-efficacy for controlling children's SHSe (OR = 1.11, p = .023) were more likely to have a home smoking ban; parents who reported smoking fewer cigarettes were more likely to adopt a home (OR = 1.62, p < .0001) or full (OR = 7.32, p = .038) ban. CONCLUSIONS Smoking bans are in-line with Healthy People 2020's tobacco objectives and may be more feasible for parents with medically compromised children for immediate SHSe reduction. Furthermore, interventions targeting full smoking bans may be a more effective for comprehensive elimination of SHSe.
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Affiliation(s)
- Jody S Nicholson
- Department of Psychology, University of North Florida, Jacksonville, FL;
| | | | - Qinlei Huang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Hui Zhang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Vida L Tyc
- Department of Pediatrics, University of South Florida, Tampa, FL
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Secondhand smoke exposure across the life course and the risk of adult-onset depression and anxiety disorder. J Affect Disord 2014; 168:367-72. [PMID: 25103633 DOI: 10.1016/j.jad.2014.07.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 07/08/2014] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The aim of this paper was to investigate the association between childhood and adulthood exposure to secondhand smoke (SHS) and depression, panic attack, and generalized anxiety disorder among adults in the United States over a 10-year period. METHODS Data were drawn from the Midlife Development in the United States (MIDUS) Waves 1 and 2 (N=2053). Self-reported childhood and adulthood SHS exposure at Wave 1 (1994) was examined in relation to incident depression, panic attack, and generalized anxiety disorder 10 years later at Wave 2 (2005). RESULTS Childhood SHS alone was not associated with mood and anxiety disorders in adulthood. Exposure to SHS in both childhood and adulthood was associated with increased depression and panic attack in adulthood. These associations did not appear to be due to confounding. LIMITATIONS SHS exposure was measured via self-report; biological data confirming exposure were not collected. More objective measures of SHS exposure are needed in future studies. CONCLUSIONS In summary, persistent exposure to SHS across the life course may be associated with increased risk of depression and panic attacks. Our results are consistent with prior findings and extend earlier results by showing a relationship between SHS exposure and mental health problems over time. Replication with biological measures of SHS over time is a necessary next step toward better understanding the pathways explaining these relationships.
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Predictors of indoor smoking at young children's homes--a cross-sectional study. Eur J Pediatr 2014; 173:1187-91. [PMID: 24710648 DOI: 10.1007/s00431-014-2310-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 03/13/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED The aim of the study was to determine factors associated with indoor smoking in homes (ISIH) using a sample of households with at least one child aged 3 or younger and at least one smoking adult. In a defined German region, all households (n = 3,570) with a child aged 3 or younger were invited to participate in a study that tested the efficacy of an intervention for reducing exposure to environmental tobacco smoke. In 1,282 households, at least one parent reported daily smoking. Among these, 917 (71.5 %) participated in the study. ISIH was defined as smoking 'in specific rooms only' or 'everywhere'. Cross-sectional data were analysed using regression analysis. Among the households, 37.5 % reported ISIH. ISIH was more likely if the youngest child had not visited a nursery (OR, 1.81; CI, 1.21-2.70) and if no private outdoor area was present (OR = 4.38, CI, 2.64-7.25). Lower household education level and partly unemployment in dual-parent households were associated with ISIH. CONCLUSION Fostering nursery attendance and availability of a private outdoor area may protect young children living in household with smoking parents from environmental tobacco smoke.
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Correlates of smoke-free home policies in Shanghai, China. BIOMED RESEARCH INTERNATIONAL 2014; 2014:249534. [PMID: 25061606 PMCID: PMC4100358 DOI: 10.1155/2014/249534] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/03/2014] [Accepted: 06/15/2014] [Indexed: 11/24/2022]
Abstract
Background. Approximately 63.7% of nonsmokers in China are exposed to secondhand smoke (SHS) in their homes. The current study documents the prevalence and correlates of smoke-free home policies in Shanghai, as well as reasons for implementing such a policy and places where smoking is most commonly allowed. Methods. We conducted in-person surveys of 500 participants using a multistage proportional random sampling design in an urban and suburban district. Results. Overall, 35.3% had a smoke-free home policy. In the logistic regression, having higher income, not having smokers in the home, having children in the home, having fewer friends/relatives who permit smoking at home, and not being a current smoker were correlates of having a smoke-free home policy (P < 0.05). Concern about the health impact of SHS was reportedly the most important reason for establishing a smoke-free home. Among participants with no or partial bans, the most common places where smoking was allowed included the living room (64.2%), kitchen (46.1%), and bathroom (33.8%). Conclusions. Smoke-free home policies were in place for a minority of households surveyed. Establishing such a policy was influenced by personal smoking behavior and social factors. These findings suggest an urgent need to promote smoke-free home policies through tobacco control programs.
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Home smoking policies in urban households with children and smokers. Prev Med 2014; 62:30-4. [PMID: 24370456 DOI: 10.1016/j.ypmed.2013.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 12/11/2013] [Accepted: 12/14/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We identified household, child, and demographic characteristics associated with not having a smoking ban and having a rule about smoking in the presence of children in an urban population. METHOD We conducted a cross-sectional random digit dial telephone survey (n=456) of Philadelphia parents in June 2012. RESULTS Forty-eight percent of homes reported a full smoking ban. In homes that allowed smoking, over half allowed smoking in front of children. Cigarettes smoked in the home decreased as the restrictiveness of the bans increased. Multinomial logistic regression analyses showed that compared to having a full ban, banning smoking only in the presence of children was associated with being African-American, having a child >5 years old, and having an asthma-free child. These characteristics, as well as having both parents as smokers and not having an outdoor space, were also associated with not having any restrictions. CONCLUSION It is possible that households attempt to reduce home smoking by limiting smoking in the presence of children. Health communication messages should be used to inform families about the lingering effects of SHS in the home even when smoking does not occur in the presence of a child.
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Rees VW, Keske RR, Blaine K, Aronstein D, Gandelman E, Lora V, Savage C, Geller AC. Factors influencing adoption of and adherence to indoor smoking bans among health disparity communities. Am J Public Health 2014; 104:1928-34. [PMID: 25208003 DOI: 10.2105/ajph.2013.301735] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed current home smoking behaviors and secondhand smoke (SHS) levels among parents of children in low-income, racial/ethnic minority communities in Massachusetts. METHODS We used a cross-sectional design to assess home smoking rules, smoking status, cigarettes smoked in the home, and barriers and benefits to attaining a smoke-free home among 138 caregivers (mean age=30.0 years; 92% women) of children aged 0 to 6 years, between April 2010 and September 2012. Indoor SHS was assessed using a nicotine dosimeter. RESULTS Households with no ban reported a higher weekly mean number of cigarettes smoked in the home (114 cigarettes/week) than homes with partial (71 cigarettes/week) or complete (30 cigarettes/week) bans (P<.01). Smoking occurred outside more than inside homes with partial or complete bans. Air nicotine levels were positively associated with no household smoking ban, current smoking by the caregiver, and smoking indoors. CONCLUSIONS Strategies to reduce home SHS should focus on a "complete" home smoking ban and smoking cessation. SHS mitigation strategies such as smoking outside were associated with lower SHS among participants unable to maintain a complete ban, and might enhance the likelihood of longer term success while immediately reducing home SHS.
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Affiliation(s)
- Vaughan W Rees
- Vaughan W. Rees and Robyn R. Keske are with the Center for Global Tobacco Control, Department of Social & Behavioral Sciences, Harvard School of Public Health, Boston, MA. Kevin Blaine and Alan C. Geller are with the Department of Social & Behavioral Sciences, Harvard School of Public Health. David Aronstein and Ediss Gandelman are with the Boston Alliance for Community Health. Vilma Lora is with the City of Lawrence Mayor's Health Task Force, MA. Clara Savage is with Common Pathways CHNA 8, Worcester, MA
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Hennessy M, Bleakley A, Mallya G, Romer D. The effect of household smoking bans on household smoking. Am J Public Health 2014; 104:721-7. [PMID: 24524533 DOI: 10.2105/ajph.2013.301634] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Because household smoking levels and adoption of domestic smoking rules may be endogenously related, we estimated a nonrecursive regression model to determine the simultaneous relationship between home smoking restrictions and household smoking. METHODS We used data from a May-June 2012 survey of Philadelphia, Pennsylvania, households with smokers (n = 456) to determine the simultaneous association between smoking levels in the home and the presence of home restrictions on smoking. RESULTS We found that home smoking rules predicted smoking in the home but smoking in the home had no effect on home smoking restrictions. CONCLUSIONS Absent in-home randomized experiments, a quasi-experimental causal inference suggesting that home smoking rules result in lower home smoking levels may be plausible.
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Affiliation(s)
- Michael Hennessy
- Michael Hennessy, Amy Bleakley, and Daniel Romer are with the Annenberg Public Policy Center, University of Pennsylvania, Philadelphia. Giridhar Mallya is with the Philadelphia Department of Public Health, Philadelphia, PA
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Murphy-Hoefer R, Madden P, Maines D, Coles C. Prevalence of smoke-free car and home rules in Maine before and after passage of a smoke-free vehicle law, 2007-2010. Prev Chronic Dis 2014; 11:130132. [PMID: 24433624 PMCID: PMC3899850 DOI: 10.5888/pcd11.130132] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This is the first study to examine the prevalence of self-reported smoke-free rules for private cars and homes before and after the passage of a smoke-free vehicle law. METHODS Data were examined for 13,461 Maine adults aged 18 or older who participated in the Behavioral Risk Factor Surveillance System, a state-based telephone survey covering health topics. Self-reported smoke-free car and home rules, smoking behavior, and demographic variables of age, sex, education, income, and children in household were analyzed for prevalence before and after the state's smoke-free vehicle law was passed. RESULTS Prevalence of smoke-free car and home rules was significantly higher after Maine's smoke-free vehicle law was passed in the state (P = .004 for car rules and P = .009 for home rules). Variations in smoking rules differed by smoking and demographic variables. People with household incomes of less than $20,000 saw an increase of 14.3% in smoke-free car rules; overall, those with annual incomes of less than $20,000 and those with less than a high school education reported a lower prevalence of smoke-free car rules both before and after the law was passed than did people with higher incomes and higher education levels. The prevalence of smoke-free home rules after the law was implemented was higher among those with 4 or more years of college education than among those with lower levels of education (P = .02). CONCLUSION The prevalence of smoke-free car and home rules among Maine adults was significantly higher after the passage of a statewide smoke-free vehicle law. This apparent change in smoke-free rule prevalence may be indicative of changing social norms related to the unacceptability of secondhand smoke exposure.
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Affiliation(s)
- Rebecca Murphy-Hoefer
- School of Community and Population Health, University of New England, 716 Stevens Ave, Portland, ME 04103. E-mail:
| | | | - Dorean Maines
- Partnership for a Tobacco-Free Maine, Augusta, Maine
| | - Carol Coles
- Partnership for a Tobacco-Free Maine, Augusta, Maine
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