DENVER – Parents who smoke are more likely to ban smoking at home if they have a child younger than age 10 years, if they don’t allow smoking in the car, if there’s just one or two smokers in their house, and if only the father smokes, according to a survey study presented at the annual meeting of the Pediatric Academic Societies.
The findings "suggest opportunities for intervention with smoking households. Some things that come to mind are [if you are caring for] a child who is on the younger side, maybe you’ll have increased traction for [advocating] a smoke-free home. Maybe you want to work on [encouraging a] smoke-free car and smoke-free home synergistically" because the two seem to correlate, said senior author Dr. Jonathan P. Winickoff of the department of pediatrics at Massachusetts General Hospital and Harvard Medical School, both in Boston.
Because homes are where children are most exposed to secondhand smoke, he and his colleagues wanted to see what factors were associated with a home-smoking ban in order to help clinicians know where to focus their efforts.
"We thought that if we could identify what some of these associated factors were, it might give us some clues about how best to intervene," Dr. Winickoff said.
They surveyed 661 smoking parents in seven pediatric practices. Half were white, 22% were black, 18% Hispanic, and 10% other. About half reported that "no one is allowed to smoke anywhere in the house," and that no one had smoked at home in the past 3 months.
Odds ratios in the study were all statistically significant. For example, if there was a child younger than age 5 years at home, the adjusted OR for a smoke-free home was 3.17; for a child aged 6-10 years old, the OR was 2.01. The OR for a smoke-free home was 2.21 if there was just one or two smokers living in the house, and 2.45 if only the father smoked. If parents banned smoking in the car, the OR for a smoke-free home was 4.13.
Other factors made a home-smoking ban less likely. If parents came to the practice for a sick-child visit, the adjusted OR for a smoke-free home was 0.46, which makes sense, Dr. Winickoff said, because smoking parents are more likely to have sicker children.
Being on Medicaid rather than private insurance also made a smoke-free home less likely (OR, 0.46), as did being black (OR, 0.47) or having a parent who smoked more than 10 cigarettes per day (OR, 0.46).
However, because the results were based on parents’ self-reports, they may have underestimated the exposure of children to smoking in the home. "Who wants to admit to their [infant’s] being exposed to secondhand smoke?" Dr. Winickoff asked.
Dr. Winickoff said he had no relevant financial disclosures. The study was funded by the National Cancer Institute, the National Institute on Drug Abuse, the Agency for Healthcare Research and Quality, and the American Academy of Pediatrics.