Smoking and Looked-After Children: A Mixed-Methods Study of Policy, Practice, and Perceptions Relating to Tobacco Use in Residential Units.
Despite the implementation of smoke-free policies by local authorities and a statutory requirement to promote the health and well-being of looked-after children and young people in England, rates of tobacco use by this population are substantially higher than in the general youth population. A mixed-methods study, comprising a survey of residential care officers in 15 local authority-operated residential units and semi-structured, face-to-face interviews with residential carers in three local authority-operated residential units, was conducted in the East Midlands. Survey data were descriptively analysed; and interview data were transcribed and analysed using thematic framework analysis. Forty-two care officers (18% response rate) completed the survey, and 14 participated in the interviews. Despite reporting substantial awareness of smoke-free policies, a lack of adherence and enforcement became apparent, and levels of reported training in relation to smoking and smoking cessation were low (21%). Potential problems relating to wider tobacco-related harms, such as exploitative relationships; a reliance on tacit knowledge; and pessimistic attitudes towards LAC quitting smoking, were indicated. The findings highlight the need for the development of comprehensive strategies to promote adherence to and enforcement of local smoke-free policy within residential units for looked-after children and young people, and to ensure appropriate support pathways are in place for this population.
UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology &amp; Public Health, University of Nottingham, Nottingham NG5 1PB, UK. lisa.huddlestone@nottingham.ac.uk.
Lisa
L
Huddlestone
UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology &amp; Public Health, University of Nottingham, Nottingham NG5 1PB, UK. catherine.pritchard@nottingham.ac.uk.
Catherine
C
Pritchard
Department of Health Sciences, University of York, York YO10 5DD, UK. elena.ratschen@york.ac.uk.
Elena
E
Ratschen
D000328:Adult; D000368:Aged; D017028:Caregivers / Q000706:statistics & numerical data*; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D061845:Smoke-Free Policy; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder; D055815:Young Adult
looked-after children; residential care; smoking; smoking cessation