title: Children, smoking households and exposure to second-hand smoke in the home in rural Australia: analysis of a national cross-sectional survey.
abstract: OBJECTIVE
  This paper aimed to explore the association between rurality and (1) household smoking status and (2) home second-hand smoke exposure, in households with children aged 0-14 years.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Households across Australia.
  
  
  METHODS
  Households across the country were randomly selected to provide a nationally representative sample. Respondents were persons aged 12 years or older in each household who were next going to celebrate their birthday.
  
  
  METHODS
  Household smoking status and smoking inside the home.
  
  
  METHODS
  The 2010 Australian National Drug Strategy Household survey data were analysed to explore the prevalence of household smoking and home second-hand smoke exposure in rural and urban households with children. Multivariable logistic regression was used to explore the association of rurality with household smoking and with home second-hand smoke exposure, controlling for potential confounders.
  
  
  RESULTS
  Households with children were more likely to be smoking households (35.4%, 95% CI 34.2% to 36.5%) than households without children (32.1%, 95% CI 31.3% to 32.8%). Both household smoking (43.6% (95% CI 41.5% to 45.7%) vs 31.4% (95% CI 30.0% to 32.8%)) and home second-hand smoke exposure (8.0% (95% CI 6.8% to 9.1%) vs 5.2% (95% CI 4.5% to 5.8%)) were significantly more common for rural children. In multivariate analyses controlling for confounding factors, rurality remained associated with smoking households (OR 1.21, 95% CI 1.07 to 1.37), whereas it did not remain associated with children's home second-hand smoke exposure (OR 1.07, 95% CI 0.85 to 1.35). Larger household size, low socioeconomic status and being a single-parent household were the main drivers of home second-hand smoke exposure.
  
  
  CONCLUSIONS
  The proportion of smoking households with children, and the number of children regularly exposed to second-hand smoke in their homes remain important public health concerns. Smoking cessation support and tobacco control policies might benefit from targeting larger and/or socioeconomically disadvantaged households including single-parent households.
authors.affiliation: University Centre for Rural Health, University of Sydney School of Public Health, University of Sydney, Lismore, New South Wales, Australia.
authors.forename: Jo M
authors.initials: JM
authors.lastname: Longman
authors.forename: Megan E
authors.initials: ME
authors.lastname: Passey
keywords: Australia; Children; Environmental Tobacco Smoke; Rural; Secondhand smoke