Population level policy options for increasing the prevalence of smokefree homes.
OBJECTIVE
To identify and evaluate the options for population level government policies to increase the prevalence of homes free of secondhand smoke.


METHODS
The literature was searched for population level policy options and evidence on them. Three criteria were used to evaluate the policy options: effectiveness, the reductions on inequalities in secondhand smoke exposure, and cost effectiveness. The setting was four developed, English speaking jurisdictions: Britain, USA, Australia, and New Zealand.


RESULTS
Evidence from all four countries shows some association between relatively comprehensive tobacco control programmes and lower prevalence levels of smoking in homes. The evidence of the effect of such programmes on inequalities in smokefree home prevalence is limited. No published evidence was found of the cost effectiveness of the programmes in achieving changes in smokefree homes. Within comprehensive programmes, there is some indirect evidence that some mass media campaigns could increase the prevalence of smokefree homes. Structural options that have potential to support smokefree homes include smokefree places legislation, and laws for the protection of children.


CONCLUSIONS
The available evidence to date suggests that comprehensive tobacco control programmes (to reduce the prevalence of smoking in the total population) are likely to be the most effective and sustainable option for increasing the prevalence of smokefree homes.
Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, New Zealand. gthomson@wnmeds.ac.nz
George
G
Thomson
Nick
N
Wilson
Philippa
P
Howden-Chapman
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D005192:Family Health; D005260:Female; D006291:Health Policy; D006293:Health Promotion / Q000331:legislation & jurisprudence*; D006798:Housing / Q000331:legislation & jurisprudence* / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D000074606:Smoking Prevention; D019460:Tobacco Industry; D014028:Tobacco Smoke Pollution / Q000517:prevention & control
D014028:Tobacco Smoke Pollution