Predicting Adoption of Home Smoking Restriction by Inner-city Black Smokers

Objective: To identify predictors of future adoption of home smoking restriction (HSR), given that 40% of inner-city smokers report current HSR. Design: Secondary analysis of data on smokers enrolled in a double-blind, placebo-controlled, randomized trial of bupropion hydrochloride for smoking cessation. Setting: Community health center in Kansas City, Kan, from August 1, 2000, to December 31, 2001. Participants: Six hundred eligible black smokers, at least 18 years old, who smoked at least 10 cigarettes per day and were interested in quitting within the next 30 days. Enrollment was limited to 1 smoker per household. Main Outcome Measure: Adoption of HSR by 6 months by those who did not have it at baseline. Result: Baseline HSR was reported by 36% of all smokers. Of 383 smokers without baseline HSR, 311 smokers had complete baseline and 6-month data. Thirty-seven percent of households without HSR at baseline had adopted HSR by 6 months. Adoption was associated with a nonsmoking adult or children in the home, progress in stage of change, and smoking cessation. Odds of adopting HSR increased with progress in stage of change (odds ratio [OR], 4.20), baseline preparatory stage of change (OR, 3.28), and having a nonsmoking partner (OR, 2.35) or children (OR, 1.75) in the home. Conclusions: A smoker's motivation to quit and the presence in the home of a nonsmoking adult or of children predict adoption of HSR by inner-city black smokers. Therefore, health professionals should motivate the smoker toward HSR and the nonsmoking partner toward advocating home smoking bans, thereby eliminating environmental tobacco smoke in the home.