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Parental Practices and Attitudes Related to Smoke-Free Rules in Homes, Cars, and Outdoor Playgrounds in US Households With Underage Children and Smokers, 2010–2011

Parental Practices and Attitudes Related to Smoke-Free Rules in Homes, Cars, and Outdoor Playgrounds in US Households With Underage Children and Smokers, 2010–2011

ORIGINAL RESEARCH — Volume 12 — June 18, 2015

Xiao Zhang, PhD; Ana Martinez-Donate, PhD; Natalie Rhoads, MPH

Suggested citation for this article: Zhang X, Martinez-Donate A, Rhoads N. Parental Practices and Attitudes Related to Smoke-Free Rules in Homes, Cars, and Outdoor Playgrounds in US Households With Underage Children and Smokers, 2010–2011. Prev Chronic Dis 2015;12:140553. DOI: http://dx.doi.org/10.5888/pcd12.140553.

PEER REVIEWED

On this Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables
• Appendix

Abstract

Introduction
A smoke-free environment protects children from exposure to involuntary smoke and also can reduce or prevent future smoking behavior. The purpose of this study was to examine levels and correlates of parental behavior and attitudes related to voluntary smoke-free rules in homes, cars, and outdoor children’s play areas among US households with underage children and 1 or more smoking parents.

Methods
We used data from the 2010–2011 Tobacco Use Supplement to the Current Population Survey and logistic regressions to model behavior and attitudes related to voluntary smoke-free rules in 3 settings.

Results
Overall, 60.1% of households with children and at least 1 smoking parent had voluntary smoke-free home rules. Approximately 84.6% and 71.5% of parents thought that smoking should not be allowed inside cars with children present and in outdoor play areas, respectively. Positive parental behavior and attitudes related to voluntary smoke-free rules were more likely among households with 2 parents, parents of higher education and household income, Hispanic parents, and parents of infants (P < .05).

Conclusion
Tobacco control and prevention efforts are needed to promote the voluntary adoption of smoke-free rules in homes, private cars, and outdoor children’s play areas. Most parents from smoker households with underage children were supportive of smoke-free laws for cars and outdoor children’s play areas, providing evidence and encouragement to policy makers to take action to restrict smoking in these locations.

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Introduction

Children living with 1 or more smoking parents are at increased risk for involuntary smoke exposure, which can cause many negative health outcomes (1). Children living with smokers are also more likely to smoke, even after accounting for other sociodemographic factors (2,3). A smoke-free environment can not only protect children from exposure to involuntary smoke, but also convey an antitobacco social norm that prevents and reduces smoking behavior in the future (4–7). The home, the car, and children’s outdoor play areas are 3 primary sources of involuntary smoke exposure for children (8).

Half of US households with underage children and at least 1 smoking parent did not have a voluntary smoke-free home rule by 2007, versus more than 90% of households with children but no smoking parents (9). However, it is unclear what the prevalence has become in recent years. Furthermore, research has examined voluntary smoke-free rules in cars (10–12) and has found overwhelming support among the US general population for voluntary smoke-free car policies when children are present (13). Yet, support for voluntary car rules has not been examined among households with children and at least 1 smoking parent, a vulnerable subset of households. Even less is known about attitudes toward smoking restrictions in outdoor children’s play areas like playgrounds and sport fields.

The 2010–2011 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) collected information on respondents’ reports of voluntary smoke-free home rules and attitudes related to smoking restrictions in cars and outdoor children’s play areas. Attitudes are theoretical determinants and good predictors of behaviors (14) and also reflect levels of support for future legislation to expand public smoke-free laws. Using data from this survey, we aimed to update the prevalence of voluntary smoke-free home rules and examine the distribution of parental attitudes related to voluntary smoke-free rules in cars and outdoor children’s play areas among US households with underage children and 1 or more smoking parents during 2010–2011. We also investigated parental and household factors associated with these outcomes.

Acknowledgments

This study received no financial support.

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Author Information

Corresponding Author: Ana Martinez-Donate, PhD, Department of Population Health Sciences, University of Wisconsin-Madison, 610 N. Walnut St, Madison, WI 53726. Telephone: 608-261-1380. Email: martinezdona@wisc.edu.

Author Affiliations: Xiao Zhang, Natalie Rhoads, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin.

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