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Secondhand smoke education

Health Factors: Tobacco Use
Decision Makers: Local Government State Government Grantmakers Healthcare Professionals & Advocates Nonprofit Leaders Public Health Professionals & Advocates
Evidence Rating: Mixed Evidence
Population Reach: 20-49% of WI's population
Impact on Disparities: Likely to increase disparities

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Secondhand smoke education informs smokers and non-smokers of the dangers of secondhand smoke. These efforts encourage smokers to smoke less in their homes and non-smokers to implement home smoking bans. Education can be delivered through counseling, health care programs, home visiting, informational materials, or media messages. Educational efforts may be implemented alone, combined with biological feedback (e.g., cotinine feedback), or delivered as part of a multi-component intervention.

Expected Beneficial Outcomes

Reduced exposure to secondhand smoke

Evidence of Effectiveness

There is mixed evidence about the effects of secondhand smoke education on tobacco use and secondhand smoke (SHS) exposure in the home. Educational interventions have been shown to reduce SHS exposure in some circumstances, but often appear to have no effect on exposure. Additional evidence is needed to confirm effects and understand which specific interventions are effective (Cochrane-Baxi 2014, Baxter 2011).

Intensive parental counseling and motivational interviewing have been shown to reduce children’s SHS exposure in some circumstances, but often have no effect on SHS exposure (Collins 2015, Cochrane-Baxi 2014, Baxter 2011). Home visits from counselors or coaches appear to reduce SHS in homes, though some tobacco smoke pollution remains (Rosen 2015). Selected interventions for families with infants and small children may also increase home smoking bans and family avoidance of SHS (Brown 2015).

Overall, less intensive interventions, such as brief advice or counseling for family and caregivers, do not appear to affect SHS exposure (Cochrane-Baxi 2014). However, select interventions, such as an Atlanta-based effort that includes three mailings and a coaching call, appear to increase home smoking bans and SHS exposure among both smokers and non-smokers, and families with and without children (Kegler 2015).

A study of asthma education and motivational interviewing for parents of premature infants in a Rochester, NY NICU suggests a combined approach may reduce infants’ exposure more than education alone, but differences were not sustained over the longer term (Blaakman 2015). Similarly, a study of families receiving a multi-component intervention to reduce SHS exposure among children undergoing treatment at a pediatric oncology hospital indicates that participating families were more likely to adopt a home smoking ban by three months than peer families; by 12 months both groups were equally likely to have a ban in place (Nicholson 2015).

Implementation Resources

ALA-Smoke-free housing - American Lung Association (ALA). Smokefree policies in multi-unit housing: Steps for success. Accessed on February 10, 2017
ANR-Smokefree - American for Nonsmokers’ Rights (ANR). Smokefree lists, maps, and data. Accessed on February 10, 2017
US EPA-Smoke-free homes kit - US Environmental Protection Agency (US EPA). Smoke-free Homes Community Action Kit. Accessed on February 28, 2017

Citations - Evidence

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 February 10, 2017
Blaakman 2015* - Blaakman SW, Borrelli B, Wiesenthal EN, et al. Secondhand smoke exposure reduction after NICU discharge: Results of a randomized trial. American Pediatrics. 2015;15(6):605-612. Accessed on February 10, 2017
Brown 2015 - Brown N, Luckett T, Davidson PM, DiGiacomo M. Interventions to reduce harm from smoking with families in infancy and early childhood: A systematic review. International Journal of Environmental Research and Public Health. 2015;12(3):3091-3119. Accessed on February 10, 2017
Cochrane-Baxi 2014* - Baxi R, Sharma M, Roseby R, et al. Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke. Cochrane Database of Systematic Reviews. 2014;(3):CD001746. Accessed on February 10, 2017
Collins 2015* - Collins BN, Nair US, Hovell MF, et al. Reducing underserved children's exposure to tobacco smoke: A randomized counseling trial with maternal smokers. American Journal of Preventive Medicine. 2015;49(4):534-544. Accessed on February 10, 2017
Kegler 2015* - Kegler MC, Bundy L, Haardorfer R, et al. A minimal intervention to promote smoke-free homes among 2-1-1 callers: A randomized controlled trial. American Journal of Public Health. 2015;105(3):530-537. Accessed on February 10, 2017
Nicholson 2015* - Nicholson JS, McDermott MJ, Huang Q, Zhang H, Tyc VL. Full and home smoking ban adoption after a randomized controlled trial targeting secondhand smoke exposure reduction. Nicotine & Tobacco Research. 2015;17(5):612-616. Accessed on February 10, 2017
Rosen 2015 - Rosen LJ, Myers V, Winickoff JP, Kott J. Effectiveness of interventions to reduce tobacco smoke pollution in homes: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2015;12(12):16043-16059. Accessed on February 10, 2017

Page Last Updated

March 30, 2016

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