title: Family Beliefs and Behaviors About Smoking and Young Children's Secondhand Smoke Exposure.
abstract: BACKGROUND
  Home smoking bans (HSBs) reduce children's secondhand smoke exposure (SHSe), a contributor to health disparities. General psychosocial characteristics and SHSe beliefs and behaviors within the family may relate to HSB existence. This study's aim was to identify general psychosocial characteristics and SHSe beliefs associated with HSB presence and lower SHSe among children living with a smoker.
  
  
  METHODS
  Caregivers (n = 269) of Head Start preschool students (age 1-6 years) living with a smoker reported on HSBs, caregiver depressive symptoms and stress, family routines, SHSe beliefs, and household smoking characteristics. SHSe biomarkers included air nicotine in 2 areas of the home and child salivary cotinine.
  
  
  RESULTS
  One-quarter of families reported complete HSBs, and HSBs were more common among nonsmoking (37%) versus smoking caregivers (21%; p < .01). Perceived importance of HSBs differed between nonsmoking (9.7±1.0) versus smoking caregivers (9.1±2.0; p < .01). Smoking caregivers, more smokers in the home, and lower self-efficacy and intent to implement an HSB were consistently associated with lower likelihood of HSB existence and children's higher SHSe. Caregiver SHSe beliefs were more consistently associated with HSBs and SHSe than were general psychosocial factors.
  
  
  CONCLUSIONS
  Despite greater HSB likelihood and higher perceived importance of HSBs among nonsmoking versus smoking primary caregivers, SHSe reduction self-efficacy and intent are protective for Head Start students at high-risk for exposure. Pediatric healthcare providers and early education professionals may be able to support SHSe reduction efforts (e.g., smoking cessation, HSB implementation) and reduce children's SHSe with counseling strategies to address caregivers' HSB self-efficacy, intent, and related behaviors.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX; marisa.hilliard@bcm.edu.
authors.forename: Marisa E
authors.initials: ME
authors.lastname: Hilliard
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD;
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Riekert
authors.affiliation: Graduate School of Public Health, San Diego State University, San Diego, CA.
authors.forename: Melbourne F
authors.initials: MF
authors.lastname: Hovell
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD;
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Rand
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD;
authors.forename: Josie S
authors.initials: JS
authors.lastname: Welkom
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD;
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Eakin
mesh_terms: D001294:Attitude to Health; D015415:Biomarkers / Q000032:analysis; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003367:Cotinine / Q000032:analysis; D003863:Depression; D005190:Family / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007223:Infant; D008297:Male; D009538:Nicotine / Q000032:analysis; D012307:Risk Factors; D020377:Self Efficacy; D013315:Stress, Psychological; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003367:Cotinine