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PubMed2000

Exposure to and actions against passive smoking in non-smoking pregnant women in Guangzhou, China.

BACKGROUND: The objective was to describe the extent of passive smoking exposure and preventive actions against passive smoking in non-smoking pregnant women and to analyze factors associated with preventive actions. METHODS: This was a cross-sectional survey on 1449 never-smoking pregnant women who made their first prenatal visit to the Women and Children's Hospital of Guangzhou, China during 1996-97. RESULTS: 60.2% (95% Confidence Interval 57.7%-62.7%) of the never-smoking pregnant women had a husband who currently smoked. Women with smoking husbands (n=872) were more exposed to ETS than those with non-smoking husbands (n=577) at home (71% vs. 33%), in public places (77% vs. 66%) and at work (60% vs. 50% of working women), and they took less actions against passive smoking in public places. Women with better education and knowledge on smoking and passive smoking had stronger preventive actions. CONCLUSIONS: Non-smoking pregnant women in China are often exposed to passive smoking and their preventive actions are weak. Passive smoking is an important obstetric and public health problem in developing countries and deserves urgent international attention.

Adult↗
PubMed2006

[Predictors of abstinence from smoking among participants in a smoking cessation program in a health center in Japan].

PURPOSE: To identify predictors of successful smoking abstinence. METHOD: A prospective analysis was conducted of a group of 687 individuals (mean age +/- SD 49.5 +/- 14.6 years, range 20 to 81 years) comprising 518 males and 169 females, who attempted to stop smoking by participating in smoking cessation programs provided by Kamakura Health Center in Japan from September 2002 to September 2003. They were provided with free nicotine patches and referred to medical clinics for follow-up. Baseline characteristics such as age, gender, program settings, daily cigarette consumption and time to the first cigarette of the day were recorded at the start of the program. Smoking status was confirmed at the one-year follow up. In addition, the participants were asked whether they had used free nicotine patches or follow-up nicotine patches and gum. The relationships between characteristics used to assess smoking abstinence rates were first analyzed using a chi2 test. Logistic regression analysis was then employed to identify independent predictors of smoking abstinence at the one-year follow up. RESULTS: A total of 687 smokers who participated in the program were registered at the start of this study. Out of these, 528 (76.9%) were eligible because their smoking status could be confirmed at the one-year follow up. The rate of smoking abstinence at the one-year follow up was 39.2%. No significant differences were observed in the rates of smoking abstinence among the participants at the one-year follow up based on gender, daily cigarette consumption or time to the first cigarette of the day. When participants were over fifty years of age (abstinence rate 47.0%), were provided with the program conducted at the Health Center (abstinence rate 50.3%), used free nicotine patches (abstinence rate 50.7%) and received follow-up nicotine replacement therapy (abstinence rate 57.7%). they were significantly more likely to have stopped smoking than the reference groups. With the above-mentioned four predictors, adjusted odds ratios of smoking abstinence observed in the logistic regression analysis were 1.68, 1.80, 2.01 and 1.79, respectively. CONCLUSION: We found a 39.2% smoking abstinence rate at one-year follow up among smokers who were treated with free nicotine patches in the smoking cessation program by the Kamakura Health Center. It was indicated that predictors of smoking abstinence are age (over fifty years), location (at the Health Center), use of free nicotine patches and receipt of follow-up nicotine replacement therapy.

Adult↗
PubMed1995

Pediatric office-based smoking intervention: impact on maternal smoking and relapse.

OBJECTIVE: To determine the impact of a brief smoking intervention delivered by pediatricians in the context of usual well baby office visits on postnatal maternal smoking and relapse. SETTING: Forty-nine private pediatric practices including 128 practitioners. DESIGN: Randomization of pediatric practices into minimal and extended intervention sites with all enrolled mothers of newborns within a practice receiving the same level of intervention. INTERVENTION: Smoking mothers in minimal condition received a hospital packet containing written information about passive smoking and a letter advising them to quit. Those in extended condition received the hospital packet plus oral and written advice at usual well baby visits: 2 weeks, 2, 4, and 6 months. MEASUREMENTS: Smoking and relapse rates at 6 months postpartum, demographics associated with smoking status, attitudes, and knowledge in regard to passive smoking, and recall surveys of mothers in regard to receiving advice or written materials. RESULTS: Two-thousand nine-hundred-one mothers of newborns were enrolled in the study. Those in the extended condition had higher quit rates (5.9% vs 2.7%, P < .01) and lower relapse rates (45% vs 55%, P < .01) than those in the minimal condition. Mothers' educational status and the presence of a smoking partner in the home were the major demographic variables associated with smoking status at enrollment and at follow-up. Compared with smokers in the minimal condition, those in extended at 6 months postpartum had significantly better attitudes and knowledge regarding passive smoking and allowed less smoking in the home. Mothers attending extended practices reported much higher rates of receiving oral advice and written materials than those in the minimal condition. CONCLUSIONS: A brief program can lead to major increases in the willingness of pediatricians to deliver smoking advice. A 1- to 2-minute intervention delivered in the context of usual well baby care can have a positive impact on maternal smoking and especially upon relapse prevention. A recent smoking history should be obtained from all mothers of newborns so that interventions can be aimed at both cessation and relapse prevention.

Female↗
PubMed1993

[Prevalence of tobacco smoking and knowledge of harmful effects of smoking among school children in Warsaw].

The study was carried out on 1493 school children (740 girls and 753 boys) from randomly selected Warsaw schools. Among them 1006 attended classes 6 and 8 of elementary schools, and 487 attended 2nd classes of secondary schools; vocational schools, technical schools and general education secondary schools. The inquiry for data collecting was based on the variable serving for description of the prevalence of smoking and determination of the extent of knowledge possessed by the children on harmful effects of smoking. The obtained results were subjected to statistical analysis. It was found that 51% of these children, more boys than girls, had already tried smoking. Most boys smoked their first cigarette at the age or 10 and 12 years, and girls at 14 years. The first contact with cigarettes had already been made by 31% children in class 6, 55% of those in class 8 of elementary schools, 53% of students in class 2 of general education secondary schools, 71% of those in class 2 of technical schools and 79% of those in vocational schools. The first contact with smoking was not meaning that these children continued smoking; from 46% to 77% of them in various classes or schools do not smoke at all. In the studied population 84% (more often girls than boys) do not smoke, but 7% smoke daily (twice as many boys as girls) and the mean number of daily smoked cigarettes is 11. At least one weekly smoke 4% of children. The mean number of weekly cigarettes is 40, but girls smoke 29 and boys 47, on average. Less than once weekly smoke 5% of children, both girls and boys. Most children smoking daily attend 2nd classes of vocational schools.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed2000

Aversive smoking for smoking cessation.

BACKGROUND: Aversion therapy pairs the pleasurable stimulus of smoking a cigarette with some unpleasant stimulus. The objective is to extinguish the urge to smoke. OBJECTIVES: This review has two aims. First, to determine the efficacy of rapid smoking and other aversive methods in helping smokers stop smoking. Second, to determine whether there is a dose-response effect on smoking cessation at different levels of aversive stimulation. SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group trials register for studies which evaluated any technique of aversive smoking. SELECTION CRITERIA: Randomised trials which compared aversion treatments with 'inactive' procedures or which compared aversion treatments of different intensity for smoking cessation. Trials must have reported follow-up of least 6 months from beginning of treatment. DATA COLLECTION AND ANALYSIS: We extracted data in duplicate on the study population, the type of aversion treatment, the outcome measure, method of randomisation and completeness of follow-up. The outcome measure was abstinence from smoking at maximum follow-up, using the strictest measure reported by the authors. Subjects lost to follow-up were regarded as smokers. Where appropriate, we performed meta-analysis using a fixed effects model. MAIN RESULTS: Twenty four trials met the inclusion criteria. Ten included rapid smoking and ten used other aversion methods. Ten trials included two or more conditions allowing assessment of a dose-response to aversive stimulation. The odds ratio for abstinence following rapid smoking compared to control was 2.08 (95% confidence interval 1.39 to 3.12). Several factors suggest that this finding should be interpreted cautiously. A funnel plot of included studies was asymmetric, due to the relative absence of small studies with negative results. Most trials had a number of serious methodological problems likely to lead to spurious positive results. The only trial using biochemical validation of all self reported cessation gave a non significant result. Other aversion methods were not shown to be effective (odds ratio 1.19, 95% confidence interval 0.77 to 1.83). There was a borderline dose-response to the level of aversive stimulation (odds ratio 1.66, 95% confidence interval 1.00 to 2.78). REVIEWER'S CONCLUSIONS: The existing studies provide insufficient evidence to determine the efficacy of rapid smoking, or whether there is a dose-response to aversive stimulation. Milder versions of aversive smoking seem to lack specific efficacy. Rapid smoking is an unproven method with sufficient indications of promise to warrant evaluation using modern rigorous methodology.

Aversive Therapy↗
PubMed2004

Aversive smoking for smoking cessation.

BACKGROUND: Aversion therapy pairs the pleasurable stimulus of smoking a cigarette with some unpleasant stimulus. The objective is to extinguish the urge to smoke. OBJECTIVES: This review has two aims: First, to determine the efficacy of rapid smoking and other aversive methods in helping smokers to stop smoking; Second, to determine whether there is a dose-response effect on smoking cessation at different levels of aversive stimulation. SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group trials register for studies which evaluated any technique of aversive smoking. SELECTION CRITERIA: Randomized trials which compared aversion treatments with 'inactive' procedures or which compared aversion treatments of different intensity for smoking cessation. Trials must have reported follow up of least six months from beginning of treatment. DATA COLLECTION AND ANALYSIS: We extracted data in duplicate on the study population, the type of aversion treatment, the outcome measure, method of randomization and completeness of follow up. The outcome measure was abstinence from smoking at maximum follow up, using the strictest measure reported by the authors. Subjects lost to follow up were regarded as smokers. Where appropriate, we performed meta-analysis using a fixed effect model. MAIN RESULTS: Twenty-five trials met the inclusion criteria. Twelve included rapid smoking and nine used other aversion methods. Ten trials included two or more conditions allowing assessment of a dose-response to aversive stimulation. The odds ratio (OR) for abstinence following rapid smoking compared to control was 1.98 (95% confidence intervals (CI): 1.36 to 2.90). Several factors suggest that this finding should be interpreted cautiously. A funnel plot of included studies was asymmetric, due to the relative absence of small studies with negative results. Most trials had a number of serious methodological problems likely to lead to spurious positive results. The only trial using biochemical validation of all self reported cessation gave a non-significant result. Other aversion methods were not shown to be effective (odds ratio 1.15, 95% confidence interval 0.73 to 1.82). There was a borderline dose-response to the level of aversive stimulation (OR 1.66, 95% CI: 1.00 to 2.78). REVIEWERS' CONCLUSIONS: The existing studies provide insufficient evidence to determine the efficacy of rapid smoking, or whether there is a dose-response to aversive stimulation. Milder versions of aversive smoking seem to lack specific efficacy. Rapid smoking is an unproven method with sufficient indications of promise to warrant evaluation using modern rigorous methodology.

Aversive Therapy↗
PubMed2026

Depressive Symptoms and Smoking Cessation Among Adolescents and Young Adults Who Smoke: A Prospective Cohort Study.

PURPOSE: This study examined the bidirectional prospective associations between depressive symptoms and smoking cessation among adolescent and young adults who smoke. METHODS: Data on 1,151 participants aged &#x2264;25 years who smoke and receive peer-led quitline counseling in Hong Kong (2016-2022) were analyzed. Exposures included baseline depressive symptoms and smoking cessation (self-reported 7-day abstinence) at 1, 3, and 6 months; Outcome measures included smoking cessation at 1, 3, and 6 months and depressive symptoms at 6 months. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, with a score &#x2265;16 indicating at risk for depression. RESULTS: More severe baseline depressive symptoms were associated with lower odds of smoking cessation at 1, 3, and 6 months, which reversely was associated with lower depressive symptoms at 6 months (all p < .05). Similarly, being at risk for depression at baseline was associated with lower odds of smoking cessation at 1 (adjusted odds ratio [aOR] .66, 95% confidential interval [CI] .47-.93) and 3 months (aOR .71, 95% CI .52-.97). Conversely, smoking cessation at 1 (aOR .40, 95% CI .23-.69), 3 (aOR .58, 95% CI .37-.92), and 6 months (aOR .44, 95% CI .29-.69) was associated with lower odds of at risk for depression at 6 months. DISCUSSION: More severe depressive symptoms were prospectively associated with lower odds of smoking cessation, while smoking cessation was associated with lower depressive symptoms and risk for depression. Integrated interventions simultaneously addressing psychological needs and smoking are warranted, when delivered in smoking cessation programs or embedded within mental health services for youth who smoke.

Humans↗
PubMed2005

Does parental smoking cessation encourage their young adult children to quit smoking? A prospective study.

AIMS: To investigate the extent to which parental early and late smoking cessation predicts their young adult children's smoking cessation. DESIGN: Parental early smoking cessation status was assessed when children were in 3rd grade, parental late smoking cessation was assessed when children were in 11th grade, and young adult children's smoking cessation was assessed 2 years after high school. SETTING: Forty Washington State school districts participated in the Hutchinson Smoking Prevention Project. PARTICIPANTS AND MEASUREMENTS: Participants were the 1553 families in which parents were ever regular smokers who had a young adult child smoking at least weekly at 12th grade who also reported their smoking status 2 years later. Questionnaire data were gathered on parents and their young adult children (49% female and 91% Caucasian) in a cohort with a 94% retention rate. FINDINGS: Parents who quit early had children with 1.8 (OR = 1.80; 95% CI = 1.22, 2.64) times higher odds of quitting smoking for at least 1 month in young adulthood compared to those whose parents did not quit early. In contrast, there was no association (OR = 0.84; 95% CI = 0.47, 1.51) between parents quitting late and their young adult children's smoking cessation. CONCLUSIONS: Parental early smoking cessation is associated with increased odds of their young adult children's smoking cessation. Parents who smoke should be encouraged to quit when their children are young.

Adult↗
PubMed2003

Symptoms of nicotine dependence and other predictors of student smoking at school: implications for school smoking policy.

Students who violate school smoking policies present a difficult health and disciplinary issue for school officials. Professionals know little about the characteristics of students who smoke at school. In a prospective study of 679 students in two cities in central Massachusetts, researchers examined how nicotine dependence contributes to the problem of smoking at school. After three years of follow up, smoking at school was reported by 10.3% of students. Among subjects who admitted to smoking at school, 63% reported that symptoms of nicotine dependence preceded their smoking at school. After adjusting for other variables, student smokers with symptoms of nicotine dependence were nine times more likely to report smoking in school (OR 9.1, 95% CI 2.9-28.5) than were student smokers without symptoms. Smoking at school was more common among daily smokers and those who paid for their own cigarettes. Age, gender, race, and parental smoking status were not significantly associated with students' reports of smoking at school. These data suggest nicotine dependence as an important contributor to the problem of smoking at school, but not the only reason why students violate school smoking policies. Disciplinary action against students caught violating school smoking policies should be supplemented with an offer of treatment for nicotine dependence.

Adolescent↗
PubMed2006

Prisoners' attitudes towards cigarette smoking and smoking cessation: a questionnaire study in Poland.

BACKGROUND: In the last decade Poland has successfully carried out effective anti-tobacco campaigns and introduced tobacco control legislation. This comprehensive strategy has focused on the general population and has led to a considerable decrease in tobacco consumption. Prisoners constitute a relatively small part of the entire Polish population and smoking habits in this group have been given little attention. The aim of the study was to assess the prevalence of cigarette smoking in Polish male prisoners, factors determining smoking in this group, prisoners' attitudes towards smoking cessation, and to evaluate prisoners' perception of different anti-tobacco measures. METHODS: An anonymous questionnaire including personal, demographic and smoking data was distributed among 944 male inmates. Of these, 907 men aged between 17 and 62 years (mean 32.3 years) met the inclusion criteria of the study. For the comparison of proportions, a chi-square test was used with continuity correction whenever appropriate. RESULTS: In the entire group, 81% of the subjects were smokers, 12% - ex-smokers, and 7% - never smokers. Current smokers had significantly lower education level than non-smokers (p < 0.0001) and ever-smokers more frequently abused other psychoactive substances than never smokers (p < 0.0001). Stress was reported as an important factor in prompting smoking (77%). Forty-nine percent of daily smokers were aware of the adverse health consequences of smoking. The majority of smokers (75%) had attempted to quit smoking in the past. Forty percent of smoking prisoners considered an award for abstaining from cigarettes as the best means to limit the prevalence of smoking in prisons. CONCLUSION: The prevalence of cigarette smoking among Polish prisoners is high. However, a majority of smokers attempt to quit, and they should be encouraged and supported. Efforts to reduce cigarette smoking in prisons need to take into consideration the specific factors influencing smoking habits in prisons.

Adolescent↗
PubMed1998

Anti-smoking socialization: relationship to parent and child smoking status.

Anti-smoking socialization is defined as the transmission of knowledge, attitudes, and skills that prepare children to resist smoking. Three types of anti-smoking socialization are studied: parents' communication with children regarding no-smoking rules at home, health risks associated with smoking, and the disciplinary consequences of smoking. Results from a survey of children in 3rd through 8th grades (N = 937) indicate that (a) children from households where one or both parents smoke perceive less anti-smoking socialization than their peers from nonsmoking households; (b) anti-smoking socialization is positively associated with authoritative parenting; (c) children have significantly lower rates of smoking intention and initiation when parents engage in anti-smoking socialization, even if parents currently smoke. The findings offer an encouraging message to all parents Communicating anti-smoking messages may effectively discourage children from smoking.

Journal Article↗
PubMed1999

Manipulation of cigarette craving through rapid smoking: efficacy and effects on smoking behavior.

Craving is thought to play an important role in maintaining regular smoking patterns in current smokers, and in leading to relapse in smokers attempting to quit. Within the scientific community however, the concept is surrounded by controversy. In an effort to 1) identify interventions that can reliably influence cigarette cravings, and 2) assess the relationship between cigarette craving and smoking behavior, effects of aversive rapid smoking (up to nine cigarettes with puffs taken every 6 s) on self-reported craving and subsequent smoking behavior were compared to effects of self-paced smoking or no smoking. Subjects (n = 14) engaged in a rapid, self-paced or no smoking procedure at the start of three separate sessions. Craving levels, measured repeatedly during the next 3 h of no smoking, were significantly lower after rapid smoking than after either self-paced or no smoking. Measures of subsequent smoking behavior (latency to first cigarette, number of cigarettes, number of puffs) did not differ systematically across conditions. Thus, craving was reliably suppressed by aversive rapid smoking, but craving scores did not predict actual smoking behavior.

Adolescent↗
PubMed2006

Histological changes in intervertebral discs after smoking and cessation: experimental study using a rat passive smoking model.

BACKGROUND: Passive smoking has been reported to induce intervertebral disc degeneration in rats, and the objective of the present study was to histologically investigate changes in smoking-induced intervertebral disc degeneration after cessation of smoking. METHODS: Four-week-old rats were subjected to passive smoking for 8 weeks in a smoking box [20 cigarettes a day: one cigarette an hour (inhaled over 3 minutes and followed by ventilation with room air for 5 minutes)] to induce intervertebral disc degeneration. Smoke-free periods of different lengths were then established, and intervertebral discs were histologically analyzed. RESULTS: Immediately after 8 weeks of passive smoking, intervertebral discs exhibited cracks, tears, and misalignment of the annulus fibrosus, and increased fibrous tissue was seen in the nucleus pulposus. In addition, the level of interleukin-1beta in intervertebral discs was higher in the smoking group than in the non-smoking group. After cessation, progression of degeneration ceased, and the matrix of the nucleus pulposus and annulus fibrosus exhibited increased fibrous connective tissue and proteoglycan. However, there were no changes in annulus fibrosus misalignment. Interleukin-1beta levels also remained significantly elevated after 8 weeks of cessation. CONCLUSIONS: While the annulus fibrosus degeneration caused by smoking was partially irreversible after cessation of smoking, the amount of mucin (proteoglycan) in the nucleus pulposus and annulus fibrosus tended to increase after cessation, thus suggesting the possibility that smoking-induced intervertebral disc degeneration can be repaired to some degree by cessation of smoking.

Animals↗
PubMed1990

Effect of parental smoking classification on the association between parental and adolescent smoking.

Prior studies of the relationship between smoking by parents and their children have considered only current smoking by parents. In this study of 12- to 14-year-old adolescents, however, lifetime parental smoking was more strongly correlated with adolescent smoking than was current parental smoking. Indeed, lifetime parental smoking was as strongly correlated as peer smoking with adolescent smoking, and peer smoking is often considered to be the main determinant of adolescent smoking. These findings suggest that the relative role of parent smoking in adolescent smoking has been underestimated, and that new explanations for the association between parental and adolescent smoking are necessary.

Adolescent↗
PubMedDate not supplied

Do as I say: parent smoking, antismoking socialization, and smoking onset among children.

This study examined relationships between smoking and antismoking practices of parents and early onset of smoking among elementary-grade children. The parent practices we investigated were direct modeling of cigarette smoking and antismoking socialization variables, such as setting rules to eliminate cigarette smoking in the home, awareness of children's smoking behaviors, and making clear the disciplinary consequences of cigarette smoking. Surveying a sample of 1.213 third- and fifth-grade children, we found (1) children's risk of early onset of smoking increases with level of exposure to parent smoking models; (2) if one or both parents are current smokers, children who have never tried smoking have significantly greater risk of intending to smoke, perceiving easy access to cigarettes, and being ambivalent about smoking; (3) risk rates for children of former smokers indicate that parents' quitting smoking does not eradicate the effects of parent modeling; and (4) children whose parents engage in antismoking socialization have significantly lower rates of smoking onset, even if parents are current smokers. The implications of these results for preventive intervention and future research are discussed.

Age of Onset↗
PubMed2004

Predictors of current need to smoke in inmates of a smoke-free jail.

A popular correctional policy has been the implementation of smoking bans for inmates. Although there is little cigarette smoking research with this population, research with other groups suggests that high levels of post-cessation cravings are associated with smoking relapse. The present study analyzed the relationship of demographic and smoking history variables, length of time incarcerated, and future intention to smoke upon release with current need to smoke in jail inmates. Participants were 150 male inmates housed in a smoke-free county jail who were intensively interviewed about smoking behavior as part of a larger study. Results indicated that stated future intention to smoke predicted current need to smoke in inmates, while length of time in jail did not. Nicotine dependence was not related either to the current need to smoke or future intention to smoke. These findings were consistent with previous inmate smoking research and have clinical implications for inmate smokers.

Adult↗
PubMed2004

Meanings of smoking and adolescent smoking across ethnicities.

PURPOSE: To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts. METHODS: We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a "mark all that apply" strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities. RESULTS: The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was "it helps me study" (OR 3.4 and 2.6 respectively), and for Asians was "don't want to make another smoke alone" (OR 5.4). CONCLUSIONS: We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking.

Adolescent↗
PubMed2003

An exploratory study of control of smoking in the home to reduce infant exposure to environmental tobacco smoke.

This study examined control of environmental tobacco smoke (ETS) exposure in the home by new mothers and identified factors related to the establishment of home smoking control rules. Pregnant women who, at 28 weeks gestation, reported they had not smoked in the past 28 days were enrolled in a randomized smoking cessation study. Telephone interviews were conducted at 6 weeks, 3 months, 6 months, and 12 months postpartum. A Home Smoking Control Index, composed of four items (whether the mother smokes in the home, the partner smokes in the home, other household smokers are asked to smoke outside, and visitors who smoke are asked to smoke outside), was used to classify homes as having a home smoking policy in effect, no policy or an incomplete policy, or no policy needed. Sociodemographic variables and maternal self-efficacy were examined in relation to the index data among 325 women who had need to exercise control of smoking in the home: 63% had a home smoking policy in effect at 3 months, 60% at 6 months, and 64% at 12 months postpartum. Predictors of policy at 6 and 12 months included (a) having a policy in effect at the previous assessment, (b) confidence in limiting infant ETS exposure in the home, and (c) perceived difficulty in preventing exposure. Early establishment of a policy appears to be important for ensuring sustained infant ETS avoidance over time. The index measures key actions that influence infant exposure and warrants further testing for use in intervention trials.

Adolescent↗