Abstract
Few studies have examined home exposure to secondhand smoke (SHS) in China. This study aimed to document: (1) the prevalence and correlates of exposure to SHS in homes (in adult non-smokers) in Shanghai, and (2) enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8%) participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors.
Highlights
Secondhand tobacco smoke (SHS) is one of the most common and important sources of pollution in the indoor home environment
The current study documented a prevalence of home exposure to secondhand smoke (SHS) of 35.8%, lower than the average national level which may reflect changes coinciding with the provincial smoke-free legislation
Further efforts should be engaged to encourage the establishment of smoke-free home policies to protect the health of nonsmokers and children, when public smoke-free policies are implemented to help thrust the momentum of change forward
Summary
Secondhand tobacco smoke (SHS) is one of the most common and important sources of pollution in the indoor home environment. There is no safe level of exposure to SHS [1]. More than 4000 chemicals have been identified in SHS, with more than 50 of these known to cause cancer [1]. SHS and several health outcomes, such as respiratory infections, ischemic heart disease, lung cancer, and asthma has long been established. It is estimated that more than 600,000 deaths per year worldwide are caused by SHS which is more than 1% of all deaths. Women and children are disproportionally affected by exposure to SHS [2]
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