title: Cohort study of smoke-free homes in economically disadvantaged communities in the Dominican Republic.
abstract: OBJECTIVE
  To analyze household smoking-ban prevalence over time and predictors among communities in the Dominican Republic, historically a significant tobacco-growing country with few tobacco control regulations.
  
  
  METHODS
  Baseline (2004) and follow-up surveillance surveys (2006, 2007) (each n > 1 000 randomly selected households) conducted in six economically disadvantaged communities (three tobacco-growing and two each urban, peri-urban, and rural) assessed household members' demographics, health status, and household characteristics, including smoking restrictions.
  
  
  RESULTS
  Between 2004 and 2007, household smoking-ban prevalence increased in all communities, with overall rates increasing from 23.9% (2004) to 45.3% (2007). Households with smokers adopted smoking bans at lower rates (6%-17%) versus those without smokers (which had an adoption rate of 35%-58%). Logistic regression models demonstrated that the associations between allowing smoking in households with no members who smoked and being located in a tobacco-growing community, being a Catholic household, and having a member with a cardiovascular problem were statistically significant. The association between having a child under age 5 or a member with a respiratory condition and prohibiting smoking in the home was not statistically significant.
  
  
  CONCLUSIONS
  Prevalence of households banning smoking increased in all communities but remained well below rates in industrialized countries. For low- and middle-income countries or those in early stages of tobacco control, basic awareness-raising measures (including surveillance activities) may lead to statistically significant increases in household smoking-ban adoption, particularly among households with no smokers. An increase in household smoking-ban prevalence may result in changes in community norms that can lead to a further increase in the adoption of smoking bans. Having household members who smoke and being in a tobacco-growing community may mitigate the establishment of household bans. Increasing individuals' knowledge about the far-reaching health effects of secondhand smoke exposure on children and nonsmoking adults (healthy or unhealthy) may help overcome these obstacles.
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, New York, United States of America, Ann_dozier@urmc.rochester.edu.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Dozier
authors.affiliation: Centro de Atención Primaria Juan XXIII, Santiago, Dominican Republic.
authors.forename: Sergio
authors.initials: S
authors.lastname: Diaz
authors.affiliation: Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, United States of America.
authors.forename: Joseph
authors.initials: J
authors.lastname: Guido
authors.affiliation: Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic.
authors.forename: Zahira
authors.initials: Z
authors.lastname: Quiñones de Monegro
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, New York, United States of America, Ann_dozier@urmc.rochester.edu.
authors.forename: Scott
authors.initials: S
authors.lastname: McIntosh
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, New York, United States of America.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Fisher
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, New York, United States of America, Ann_dozier@urmc.rochester.edu.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Ossip
mesh_terms: D015331:Cohort Studies; D004293:Dominican Republic; D005191:Family Characteristics; D006801:Humans; D012906:Smoke; D061845:Smoke-Free Policy; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D035862:Vulnerable Populations
chemical_list: D012906:Smoke; D014028:Tobacco Smoke Pollution