Abstract
Around 40% of children are exposed to tobacco smoke, increasing their risk of poor health. Previous research has demonstrated misunderstanding among smoking parents regarding children’s exposure. The parental perceptions of exposure (PPE) measure uses visual and textual vignettes to assess awareness of exposure to smoke. The study aimed to determine whether PPE is related to biochemical and reported measures of exposure in children with smoking parents. Families with at least one smoking parent and a child ≤ age 8 were recruited. In total, 82 parents completed the PPE questionnaire, which was assessed on a scale of 1–7 with higher scores denoting a broader perception of exposure. Parents provided a sample of their child’s hair and a self-report of parental smoking habits. Parents who reported smoking away from home had higher PPE ratings than parents who smoke in and around the home (p = 0.026), constituting a medium effect size. PPE corresponded with home smoking frequency, with rare or no home exposure associated with higher PPE scores compared to daily or weekly exposure (p < 0.001). PPE was not significantly related to hair nicotine but was a significant explanatory factor for home smoking location. PPE was significantly associated with parental smoking behaviour, including location and frequency. High PPE was associated with lower exposure according to parental report. This implies that parental understanding of exposure affects protective behaviour and constitutes a potential target for intervention to help protect children.
Highlights
An estimated 40% of children are exposed globally to the harmful effects of tobacco smoke in their homes [1]
The aims of the study were to assess the relationship between perceptions of what constitutes exposure (PPE) and children’s exposure measured both by parental report and an objective measure
While it is often suggested that in order to protect children, parents must be made more aware of the harm caused to children by smoking, we propose that parents need to be made aware that exposure is occurring
Summary
An estimated 40% of children are exposed globally to the harmful effects of tobacco smoke in their homes [1]. Current research has failed to find an effective way of protecting children, and parental reports of exposure are often inaccurate. This failure may be partly due to a fundamental misunderstanding of exposure based on deficiencies in perceptions, including parental perceptions of what constitutes exposure (PPE) [3,4]. While adult smokers have some choice about whether or not to smoke, children who live, play and study in areas frequented by smokers are forcibly exposed to the harms of tobacco smoke exposure (TSE) including second-hand smoke (SHS) and third-hand smoke (THS). In addition to the well known health risks of TSE—which in children include lower respiratory infections, ear infections, asthma and sudden infant
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