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Education to reduce home exposure to secondhand smoke

Health Factors: Tobacco Use
Decision Makers: Community Organizations, Government - Local, Government - State, Healthcare Organizations
Evidence Rating: Some Evidence
Population Reach: 20-49% of WI's population
Impact on Disparities: Likely to increase disparities

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Description

Education to reduce home exposure to secondhand smoke informs smokers of the dangers of secondhand smoke, and encourages them to smoke less in their homes. Education can be delivered through counseling, health care programs, informational materials, or media messages.

Expected Beneficial Outcomes

Reduced exposure to secondhand smoke

Evidence of Effectiveness

There is some evidence that education can convince smokers to smoke less in their homes (Cochrane-Priest 2008, Baxter 2011, Wilson 2011, Baheiraei 2011, Lichtenstein 2008). Additional evidence is needed to confirm effects.

A number of specific interventions have been shown to reduce in-home smoke exposure. Intensive parental counseling (Cochrane-Priest 2008, Baxter 2011, Baheiraei 2011), and motivational interviewing (Baxter 2011) can reduce children's exposure in some circumstances. Counseling parents of asthmatic children dramatically reduced exposure in one study, but only for the most severely asthmatic children (Wilson 2011). An Oregon study finds that combining education and counseling with radon testing can persuade households to institute indoor smoking bans (Lichtenstein 2008). Interventions training children to negotiate for smoke-free homes also show positive results (Alwan 2011, Siddiqi 2010).

Implementation Examples

United States

As of 2007, 79% of American adults lived in smoke free homes (Giovino 2009). All federal and most state prisons prohibit smoking indoors (ANR-Smokefree). Six states ban smoking in nursing homes (ANR-Smokefree), and some major cities do not allow smoking in public housing (Ryan 2012). Most universities prohibit smoking in dormitories (ANR-Going smokefree).

Wisconsin

In 2007, 73% of Wisconsin's homes were smoke free (CDC-STATE); 40% percent of adult smokers and 85% of adult nonsmokers lived in smoke free homes (Giovino 2009). Smoking is banned in college dormitories, prisons, hospitals, and all common areas of multi-unit housing (CDC-STATE).

Implementation Resources

ALA - American Lung Association (ALA). Smokefree policies in multi-unit housing: Steps for success. Accessed on June 20, 2012
Webpage: http://www.lungusa.org/stop-smoking/about-smoking/smokefree-housing.html
ANR-Smokefree - American for Nonsmokers’ Rights (ANR). Smokefree lists, maps, and data. Accessed on June 20, 2012
Webpage: http://www.no-smoke.org/goingsmokefree.php?id=519
US EPA-Smoke-free homes - US Environmental Protection Agency (US EPA). Smoke-free homes: Develop your program. Accessed on June 20, 2012
Webpage: http://www.epa.gov/smokefree/community.html

Citations - Evidence

Alwan 2011* - Alwan N, Siddiqi K, Thomson H, Lane J, Cameron I. Can a community-based “smoke-free homes” intervention persuade families to apply smoking restrictions at homes? Journal of Public Health. 2011;33(1):48-54. Accessed on June 19, 2012
Webpage: http://jpubhealth.oxfordjournals.org/content/33/1/48.short
Baheiraei 2011* - Baheiraei A, Kharaghani R, Mohsenifar A, et al. Reduction of secondhand smoke exposure among healthy infants in Iran: Randomized controlled trial. Nicotine and Tobacco Research. 2011;13(9):840-7. Accessed on June 19, 2012
Webpage: http://ntr.oxfordjournals.org/content/13/9/840.abstract
Baxter 2011 - Baxter S, Blank L, Everson-Hock ES, et al. The effectiveness of interventions to establish smoke-free homes in pregnancy and in the neonatal period: A systematic review. Health Education Research. 2011;26(2):265-82. Accessed on June 19, 2012
Webpage: http://her.oxfordjournals.org/content/26/2/265.short
Cochrane-Priest 2008* - Priest N, Roseby R, Waters E, et al. Family and carer smoking control programmes for reducing children’s exposure to environmental tobacco smoke. Cochrane Database of Systematic Reviews. 2008;(4):CD001746. Accessed on June 19, 2012
Webpage: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001746.pub2/abstract
Lichtenstein 2008 - Lichtenstein E, Boles SM, Lee ME, et al. Using radon risk to motivate smoking reduction II: Randomized evaluation of brief telephone counseling and a targeted video. Health Education Research. 2008;23(2):191-201. Accessed on June 19, 2012
Webpage: http://her.oxfordjournals.org/content/23/2/191.full.pdf+html
Siddiqi 2010 - Siddiqi K, Sarmad R, Usmani RA, et al. Smoke-free homes: An intervention to reduce second-hand smoke exposure in households. International Journal of Tuberculosis and Lung Disease. 2010;14(10):1336-41. Accessed on June 20, 2012
Webpage: http://www.ingentaconnect.com/content/iuatld/ijtld/2010/00000014/00000010/art00018
Wilson 2011* - Wilson S, Farber H, Knowles S, Lavori P. A randomized trial of parental behavioral counseling and cotinine feedback for lowering environmental tobacco smoke exposure in children with asthma: Results of the LET’S manage asthma trial. Chest. 2011;139(3):581-90. Accessed on June 18, 2012
Webpage: http://chestjournal.chestpubs.org/content/139/3/581.short

Citations - Implementation Examples

ANR-Going smokefree - Americans for Nonsmokers’ Rights (ANR). Getting started. Accessed on June 20, 2012
Webpage: http://www.no-smoke.org/goingsmokefree.php?dp=d13|p136
ANR-Smokefree - American for Nonsmokers’ Rights (ANR). Smokefree lists, maps, and data. Accessed on June 20, 2012
Webpage: http://www.no-smoke.org/goingsmokefree.php?id=519
CDC-STATE - Centers for Disease Control and Prevention (CDC). State tobacco activities tracking and evaluation (STATE) system. Accessed on June 15, 2012
Webpage: http://apps.nccd.cdc.gov/statesystem/Default/Default.aspx
Giovino 2009 - Giovino GA, Chaloupka FJ, Hartman AM, et al. Cigarette smoking prevalence and policies in the 50 States: An era of change - The Robert Wood Johnson Foundation ImpacTeen tobacco chart book. Buffalo: University at Buffalo, State University of New York; 2009. Accessed on June 23, 2012
Webpage: http://www.rwjf.org/pr/product.jsp?id=43928
Ryan 2012 - Ryan E. Condo residents take neighbors to court over secondhand smoke. The Washington Post. January 17, 2012. Accessed on June 23, 2012
Webpage: http://www.washingtonpost.com/realestate/2012/01/10/gIQAKz225P_story.html

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Health Factors

Health Behaviors
Tobacco Use
Diet & Exercise
Alcohol Use
Sexual Activity
 Clinical Care
Access to Care
Quality of Care
 Social & Economic Factors
Education
Employment
Income
Family & Social Support
Community Safety
 Physical Environment
Environmental Quality
Built Environment

Decision Makers

Businesses & Employers
Community Organizations
Government - Local
Government - State
Government - Federal
Healthcare Organizations
Individuals
Schools

Evidence Rating

Level of effectiveness based on a scan of academic literature and key recommendations of leading organizations.

  • Scientifically Supported Numerous studies or systematic review(s) with positive results
  • Some Evidence Research suggests positive impacts; further study may be warranted
  • Expert Opinion Recommended by credible groups*; research evidence limited
  • Insufficient Evidence Evidence limited or unavailable; further study warranted
  • Mixed Evidence Evidence mixed; further study warranted
  • Evidence of Ineffectiveness Research consistently shows program is detrimental or has no effect

Although many policies and programs are recommended by credible groups, we apply the rating ‘expert opinion’ only when policies are recommended but limited scientific evidence of effectiveness is available.

* The American Heritage Dictionary defines credible as 'capable of being believed; plausible.' and 'worthy of confidence; reliable.' To be considered an 'expert recommendation,' policies and programs must be recommended by one or more organizations that are recognized for their impartial expertise in the area of interest and have limited evidence available.

Potential Population Reach

Portion of Wisconsin's population likely to be reached by a policy or program if implemented statewide, based on its characteristics (e.g., target population(s), geographic limitations, and potential implementers).

<1%   20-49%
1-9%   50-99%
10-19%   100%

Potential Population Reach

Portion of Wisconsin's population likely to be reached by a policy or program if implemented statewide, based on its characteristics (e.g., target population(s), geographic limitations, and potential implementers).

<1%   20-49%
1-9%   50-99%
10-19%   100%

Potential Impact on Health Disparities

Likely impact of a given policy or program on racial/ethnic, socioeconomic, geographic or other disparities in Wisconsin based on its characteristics (e.g., target audience, mode of delivery, etc.) and best available evidence related to disparities.

  • Likely to decrease disparities
  • No impact on disparities likely
  • Likely to increase disparities