Abstract
BackgroundParents with less formal education are more likely to smoke indoors, causing socioeconomic disparity in children’s exposure to second-hand smoke. However, little is known about the roles of social factors in the socioeconomic gradients of indoor smoking. We tested the potential mediating role of perceived smoking norms on the associations between education and indoor smoking among parents who smoke.MethodsIn this cross-sectional study, 822 smoking fathers and 823 smoking mothers, who lived with young children and were members of a Japanese online survey panel, participated. Structural equation modelling tested the mediating effects of perceived descriptive and subjective norms on the association between education and indoor smoking.ResultsPerceived pro-smoking norms, which were more prevalent among less-educated parents, mediated the association between education and indoor smoking. Household smoking status and worksite smoking ban also mediated this association via perceived norms, but only for fathers. Perceived descriptive norms explained 28.5% of the association for fathers and 37.6% for mothers; the corresponding percentages for perceived subjective norms were 9.8% and 26.6%, respectively.ConclusionsPerceived smoking norms, household smoking status, and a worksite smoking ban could be vital targets of a strategy aimed at reducing the socioeconomic disparity in parental home smoking behaviours.
Highlights
Parents with less formal education are more likely to smoke indoors, causing socioeconomic disparity in children’s exposure to second-hand smoke
Evidence is scarce on the mechanisms between parental socioeconomic status (SES) and indoor smoking behaviours, studies far have suggested that social norms of smoking play a key role in explaining SES inequality in smoking
The prevalence of indoor smoking behaviours was much higher among mothers (64.0%) than fathers (35.9%)
Summary
Parents with less formal education are more likely to smoke indoors, causing socioeconomic disparity in children’s exposure to second-hand smoke. While overall prevalence of children’s SHS exposure has been significantly reduced in many developed countries [6, 7], the absence of smoke-free homes or indoor smoking behaviours among less-educated parents was 3.9 times higher than that among more-educated parents in Germany [8], 6.6 times higher in Japan [9], and 11.5 times higher in Denmark [10]. In Japan, the average prevalence of infants exposed to SHS decreased from 36.8% in 2001 to 14.4% in 2010 [9] In both years, 51.5% and 28.1% of infants of less-educated parents were exposed to parental indoor smoking at home, respectively. Evidence is scarce on the mechanisms between parental SES and indoor smoking behaviours, studies far have suggested that social norms of smoking play a key role in explaining SES inequality in smoking
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