Abstract
BackgroundChildren’s second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. Personalized household air-quality measurements can promote changes in smoking that reduce SHS exposure. The ‘First Steps 2 Smoke-free’ (FS2SF) intervention is the first to trial this approach delivered as part of health professionals’ routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied.Methods120 women were recruited from the NHS First Steps Programme, which supports disadvantaged mothers. They received either personalized feedback on their home air quality and advice on reducing SHS or standard SHS advice. Qualitative interviews with 15 mothers were analyzed thematically using the Capability, Opportunity, Motivation, Behaviour (COM-B) model.ResultsThe intervention increased women’s capability to change home-smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others’ smoking in the home.ConclusionsThe FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage.
Highlights
Exposure to second-hand smoke (SHS) in the home causes adverse health outcomes in children and adults.[1,2,3] The proportion of children exposed to SHS in the home has declined in the UK, but there is continuing inequality in exposure levels.[4,5] In Scotland, under 1% of children in the most affluent areas report regular SHS home exposure, compared to 15% of childrenje in the most deprived areas.[5]
To understand why FS2SF had no effect, this paper reports the findings of qualitative interviews with women who received the enhanced intervention, which explored their experiences of the intervention and why behaviour change outcomes varied
Interview findings indicated that participants found the intervention acceptable and understood the data they were shown, in some cases with assistance from their First Steps (FS) worker
Summary
Exposure to second-hand smoke (SHS) in the home causes adverse health outcomes in children and adults.[1,2,3] The proportion of children exposed to SHS in the home has declined in the UK, but there is continuing inequality in exposure levels.[4,5] In Scotland, under 1% of children in the most affluent areas report regular SHS home exposure, compared to 15% of childrenje in the most deprived areas.[5] Disadvantaged parents can face challenges in creating and maintaining a smoke-free home, when sole caring for young children in accommodation with limited access to suitable space to smoke outside.[6,7,8,9]. A range of interventions have been developed to promote smoke-free homes, for example using counselling approaches, feedback of a biological measure of children’s SHS exposure, school-based strategies, nicotine-replacement therapy and educational materials. Children’s second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. The ‘First Steps 2 Smoke-free’ (FS2SF) intervention is the first to trial this approach delivered as part of health professionals’ routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied
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