The effect of smoke-free homes on adult smoking behavior: A review

Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, CA 92093-0901, USA.
Nicotine & Tobacco Research (Impact Factor: 3.3). 08/2009; 11(10):1131-41. DOI: 10.1093/ntr/ntp122
Source: PubMed


Smoke-free homes are known to reduce exposure to harmful secondhand smoke. Recent studies suggest that they may also positively affect smoking behavior among smokers themselves.
We review the literature on the effect of smoke-free homes on adult smoking behavior. The literature search included database (PubMed) and manual searches of related articles and reference lists for English-language studies published from 1 January 1990 to 16 November 2008.
We identified 16 cross-sectional and 7 longitudinal studies of the population-level association of smoke-free homes with adult smoking behavior. Additional studies provided population estimates of trends in and correlates of smoke-free homes. Prevalence of smoke-free homes varies but has been increasing over time in the countries studied and was greater among smokers who were younger, of higher income or educational attainment, smoked fewer cigarettes per day, or lived with a nonsmoking adult or child. Both longitudinal and cross-sectional studies showed that smokers who had or who newly implemented a smoke-free home were significantly more likely to make a quit attempt and to be abstinent, after controlling for confounding factors. In longitudinal studies, those who continued to smoke had a modest, but significant, decrease in cigarette consumption at follow-up.
There is strong and consistent population-level evidence that a smoke-free home is associated with increased smoking cessation and decreased cigarette consumption in adult smokers. As they not only reduce exposure to secondhand smoke but also increase cessation rates, promotion of smoke-free homes should be a key element in tobacco control programs.

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    • "This educational disparity in SHS exposure among Bangladeshis underscores the need for targeted educational interventions to improve health-related knowledge among the less educated Bangladeshis and emphasize the promotion of smoke-free home policies to this disadvantaged population group. Educating smokers about smoke-free homes would also increase smokers’ likelihood of quitting smoking and decrease cigarette consumption [22]. "
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    ABSTRACT: Background Exposure to secondhand smoke (SHS) is a serious global public health problem. Understanding the correlates of SHS exposure could guide the development of evidence based SHS exposure reduction interventions. The purpose of this study is to describe the pattern of and factors associated with SHS exposure among non-smoking adults in Bangladesh. Methods Data come from adult non-smokers who participated in the second wave (2010) of the International Tobacco Control Policy (ITC) Evaluation Bangladesh Survey conducted in all six administrative divisions of Bangladesh. A structured questionnaire gathered information on participants’ demographic characteristics, pattern of SHS exposure, SHS knowledge, and attitudes towards tobacco control. Exposure to SHS at home was defined as non-smokers who lived with at least one smoker in their household and who reported having no home smoking ban. The data were analyzed using chi-square tests and logistic regression procedures. Results The SHS exposure rate at home among the participants (N = 2813) was 43%. Several sociodemographic and attitudinal factors were associated with SHS exposure. Logistic regression analyses identified eight predictors of SHS exposure: being female (OR = 2.35), being aged 15–24 (OR = 2.17), being recruited from Dhaka slums (OR = 5.19) or non-tribal/non-border areas outside Dhaka (OR = 2.19) or tribal/border area (OR = 4.36), having lower education (1–8 years: OR = 2.45; illiterate: OR = 3.00, having higher monthly household income (5000 to <10,000 Taka: OR = 2.34; 10,000 Taka or more: OR = 2.28), having a father who smoked in the past or currently smokes (OR = 2.09), having lower concern about the harms of tobacco on children (unconcerned OR = 3.99; moderate concern OR = 2.26), and not knowing the fact that SHS causes lung cancer in non-smokers (OR = 2.04). Conclusions Almost half of non-smoking Bangladeshi adults are exposed to SHS at home. The findings suggest the need for comprehensive tobacco control measures that would improve public understanding about health hazards of SHS exposure at home and encourage educational initiatives to promote smoke-free homes. Interventions should deliver targeted messages to reach those in the low socioeconomic status group.
    Full-text · Article · Jul 2014 · BMC Pulmonary Medicine
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    • "Smoke-free home policies may reflect the social norms related to smoking and attitudes about smoking and SHS in environments in which there are no widespread public campaigns promoting smoke-free homes [22]. There is also consistent evidence that smoke-free home policies not only reduce exposure to SHS but also increase cessation rates and decrease cigarette consumption in adult smokers [23]. Also, smoke-free home policies may create and reinforce life-long antismoking behavioral values and norms among youth. "
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    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.
    Full-text · Article · Jul 2014 · BioMed Research International
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    • "The added value of this strategy is that it often increases the likelihood of quitting among smokers and is considered as a key factor associated with cessation attempts and success [18,29-34]. There is a strong and consistent population-level evidence that smoke-free homes are associated with increased smoking cessation and decreased cigarette consumption in adult smokers [35,36]. As Mills et al. reported, both longitudinal and cross-sectional studies have revealed that smokers who had or who newly implemented a smoke-free home were significantly more likely to make a quit attempt and to be abstinent, after controlling for confounding factors. "
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    ABSTRACT: Background Estimating the prevalence of hardcore smoking and identifying linked factors is fundamental to improve planning and implementation of effective tobacco control measures. Given the paucity of data on that topic, we aimed to assess the prevalence of and factors associated with hardcore smoking in Poland. Methods We used data from the Global Adult Tobacco Survey (GATS). GATS is a representative, cross-sectional, household based survey conducted in Poland between 2009 and 2010. Binary logistic regression analysis was used to explore the associations of socio-demographic and smoking related variables with hardcore smoking among daily smokers. Results The prevalence of hardcore smoking was 10.0% (13.0% among men and 7.3% among women) in the whole population of Poland at age 26 years and above. Hardcore smokers constitute 39.9% (41.6% among men and 37.7% among women) of all daily smokers in analyzed age frame. Being older, having started smoking at earlier ages, living in large cities (in women only), being less aware of negative health effects of smoking, having less restrictions on smoking at home was associated with higher risk of being hardcore smoker. Educational attainment and economic activity were not associated with hardcore smoking among daily smokers. Conclusions High prevalence of hardcore smokers may be a grand challenge for curbing non-communicable diseases epidemic in Poland. Our findings should urge policy makers to consider hardcore smoking issues while planning and implementing tobacco control policies. Prevention of smoking uptake, education programs, and strengthening cessation services appeared to be the top priorities.
    Full-text · Article · Jun 2014 · BMC Public Health
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