Strict smoke-free home policies among smoking parents in pediatric settings.
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.
Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY. Electronic address: deborah_ossip@urmc.rochester.edu.
Deborah J
DJ
Ossip
Yuchiao
Y
Chang
Emara
E
Nabi-Burza
Jeremy
J
Drehmer
Stacia
S
Finch
Bethany
B
Hipple
Nancy A
NA
Rigotti
Jonathan D
JD
Klein
Jonathan P
JP
Winickoff
D000293:Adolescent; D000328:Adult; D003376:Counseling; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D009819:Office Visits; D010290:Parents / Q000523:psychology; D010372:Pediatrics; D010819:Physician's Role; D061845:Smoke-Free Policy; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D055815:Young Adult
D014028:Tobacco Smoke Pollution
environmental tobacco smoke; parental smoking; secondhand smoke; smoking