Household Implementation of Smoke-Free Rules in Homes and Cars: A Focus on Adolescent Smoking Behavior and Secondhand Smoke Exposure

Michael J. Parks, John H. Kingsbury, Raymond G. Boyle, Sharrilyn Evered

    Research output: Contribution to journalArticlepeer-review

    12 Scopus citations

    Abstract

    Purpose: This study addresses the dearth of population-based research on how comprehensive household smoke-free rules (ie, in the home and car) relate to tobacco use and secondhand smoke (SHS) exposure among adolescents. Design: Analysis of 2014 Minnesota Youth Tobacco Survey. Setting: Representative sample of Minnesota youth. Participants: A total of 1287 youth who lived with a smoker. Measures: Measures included household smoke-free rules (no rules, partial rules—home or car, but not both—and comprehensive rules), lifetime and 30-day cigarette use, 30-day cigarette and other product use, and SHS exposure in past 7 days in home and car. Analysis: Weighted multivariate logistic, zero-inflated Poisson, and zero-inflated negative binomial regressions were used. Results: Compared to comprehensive rules, partial and no smoke-free rules were significantly and positively related to lifetime cigarette use (respectively, adjusted odds ratio [AOR] = 1.80, 95% confidence interval [CI] = 1.24-2.61; AOR = 2.87, 95% CI = 1.93-4.25), and a similar significant pattern was found for 30-day cigarette use (respectively, AOR = 2.20, 95% CI = 1.21-4.02; AOR = 2.45, 95% CI = 1.34-4.50). No smoke-free rules significantly predicted using cigarettes and other tobacco products compared to comprehensive rules. In both descriptive and regression analyses, we found SHS exposure rates in both the home and car were significantly lower among youth whose household implemented comprehensive smoke-free rules. Conclusions: Comprehensive smoke-free rules protect youth from the harms of caregiver tobacco use. Relative to both partial and no smoke-free rules, comprehensive smoke-free rules have a marked impact on tobacco use and SHS exposure among youth who live with a smoker. Health promotion efforts should promote comprehensive smoke-free rules among all households and particularly households with children and adolescents.

    Original languageEnglish (US)
    Pages (from-to)70-78
    Number of pages9
    JournalAmerican Journal of Health Promotion
    Volume33
    Issue number1
    DOIs
    StatePublished - Jan 1 2019

    Bibliographical note

    Funding Information:
    The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under National Research Service Award (NRSA) in Primary Medical Care, grant no. T32HP22239 (PI: Borowsky). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsement be inferred by HRSA, HHS, or the US Government.

    Publisher Copyright:
    © The Author(s) 2018.

    Keywords

    • adolescents
    • changing tobacco landscape
    • cigarette use
    • household rules
    • secondhand smoke exposure
    • smoke-free cars
    • smoke-free homes
    • smoke-free rules
    • tobacco use

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