Strict Smoke-free Home Policies Among Smoking Parents in Pediatric Settings

• Published in: Academic pediatrics Vol. 13; no. 6; pp. 517 - 523
• Main Authors: Ossip, Deborah J., PhD, Chang, Yuchiao, PhD, Nabi-Burza, Emara, MBBS, MS, Drehmer, Jeremy, MPH, Finch, Stacia, MA, Hipple, Bethany, MPH, Rigotti, Nancy A., MD, Klein, Jonathan D., MD, MPH, Winickoff, Jonathan P., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2013
• Subjects: Adolescent; Adult; Counseling; environmental tobacco smoke; Health Knowledge, Attitudes, Practice; Humans; Logistic Models; Neonatal and Perinatal Medicine; Office Visits; parental smoking; Parents - psychology; Pediatrics; Physician's Role; secondhand smoke; Smoke-Free Policy; smoking; Tobacco Smoke Pollution - prevention & control; Young Adult; parental smoking; secondhand smoke; environmental tobacco smoke; smoking
• ISSN: 1876-2859; 1876-2867; 1876-2867
• DOI: 10.1016/j.acap.2013.06.003

Abstract Objective To examine strict smoke-free home policies among smoking parents assessed in pediatric offices. Methods We analyzed baseline parental survey data from 10 control practices in a national trial of pediatric office-based tobacco control interventions (Clinical Effort Against Secondhand Smoke Exposure, CEASE). We used logistic regression models with generalized estimating equations to examine factors associated with strict smoke-free home policies. Results Subjects were 952 parents who were current smokers. Just over half (54.3%) reported strict smoke-free home policies. Few reported being asked (19.9%) or advised (17.1%) regarding policies by pediatricians. Factors associated with higher odds of policies were child 5 years or younger (adjusted odds ratio [aOR] 2.43, 95% confidence interval [CI] 1.53, 3.86), nonblack race/ethnicity (aORs 2.17–2.60, 95% CIs 1.25–5.00), non-Medicaid (HMO/private (aOR 1.84, 95% CI 1.31, 2.58); self-pay/other aOR 1.76, 95% CI 1.12, 2.78); well-child versus sick child visit (aOR 1.61, 95% CI 1.11, 2.34), fewer than 10 cigarettes per day (aOR 1.80, 95% CI 1.31, 2.47), no other home smokers (aOR 1.68, 95% CI 1.26, 2.25), only father smoking (aOR 1.73, 95% CI 1.06, 2.83), and strict smoke-free car policy (aOR 3.51, 95% CI 2.19, 5.64). Conclusions Nearly half of smoking parents did not have strict smoke-free home policies. Parents were less likely to report policies if they were heavier smokers, black, living with other smokers, or attending a sick child visit; if they did not have a young child or smoke-free car policy; if they had a child on Medicaid; and if anyone other than only the father smoked. Few pediatricians addressed or recommended strict smoke-free home policies in an office visit. The pediatric office encounter represents a currently missed opportunity to intervene regarding smoke-free homes, particularly for high-risk groups.