Car Smoking Bans Research Articles

Thirdhand Smoke Knowledge, Beliefs and Behaviors among Parents and Families: A Systematic Review.

Families play a primary role in protecting children. Thirdhand smoke (THS) is an underestimated public health issue, and health effects correlated to its exposition are emerging. The aim of this systematic review was to analyze papers focusing on knowledge, beliefs, and behaviors regarding THS among parents, families, and caregivers, published until May 2022 on MEDLINE, CINAHL, EMBASE, and the Cochrane Library. Critical appraisal of the included studies was conducted by two independent reviewers using the Joanna Briggs Institute Critical Appraisal tool. Out of the 97 articles, 8 were included in this review (two from the USA, one from Europe, and five from Asia). Although there were no restrictions on the date of publication, all the articles were published in the last 10 years, underlining that THS is an emerging concept. They were characterized by relevant heterogeneity in the study design and assessment tools. The results showed that percentages of parents who believed that THS is harmful ranged from 42.4% to 91%, but parental awareness was not always associated with the adoption of a home- and car-smoking ban or healthy behaviors. Further research is needed to understand the resistance and problems faced by parents who are aware of THS risks but unable to improve good practices.

Public support for car smoking bans in Poland: a 2022 national cross-sectional survey

ObjectiveThe objectives of this study were to assess the prevalence of self-reported secondhand smoke exposure in cars among adults in Poland and to characterise public attitudes towards the implementation of...

Family matters: the influence of partner and familial encouragement on home and car smoking bans

Background: Secondhand smoke exposure (SHSe) poses health risks to neonatal intensive care unit (NICU) infants after they are discharged; these risks can be mitigated by the implementation of parent-enforced total home and car smoking bans. Understanding the influence that various family members have on household smoking policies may inform interventions to reduce SHSe among vulnerable infants.Methods: In a cross-sectional, secondary analysis of data collected between 2013 and 2015, mothers of NICU infants who reported smoking or living with a smoker (N=242) were asked about whether members of 9 separate relationship types (e.g., partner, mother, father) encouraged or discouraged smoking in the home and car. The influence of perceived encouragement from each relationship type on the odds of having a total smoking ban in place was estimated.Results: Participants reported that partners (47%) and siblings (32%) were most likely to encourage smoking in the home/car. In a multivariate model, both partner (p=0.0002) and sibling (p=0.004) encouragement of indoor smoking decreased the likelihood of having a total smoking home and car ban in place.Conclusions: Family members have significant influence on SHSe reduction practices. Innovative family-based interventions may be needed in order to reduce SHSe in this particularly vulnerable group of infants.

Reducing Tobacco Smoke Exposure in High-Risk Infants: A Randomized, Controlled Trial

To evaluate a hospital-initiated intervention to reduce tobacco smoke exposure in infants in the neonatal intensive care unit. A randomized, controlled trial compared motivational interviewing plus financial incentives with conventional care on infant urine cotinine at 1 and 4months' follow-up. Mothers of infants in the neonatal intensive care unit (N=360) who reported a smoker living in the home were enrolled. Motivational interviewing sessions were delivered in both the hospital and the home. Financial incentives followed session attendance and negative infant cotinine tests postdischarge. The intervention effect on infant cotinine was not significant, except among mothers who reported high baseline readiness/ability to protect their infant (P≤.01) and mothers who completed the study within 6months postdischarge (per protocol; P≤.05). Fewer mothers in the motivational interviewing plus financial incentives condition were smoking postdischarge (P≤.01). More mothers in the motivational interviewing plus financial incentives group reported a total home and car smoking ban at follow-up (P≤.05). Motivational interviewing combined with financial incentives reduced infant tobacco smoke exposure in a subset of women who were ready/able to protect their infant. The intervention also resulted in less maternal smoking postpartum. More robust interventions that include maternal and partner/household smoking cessation are likely needed to reduce the costly effects of tobacco smoke exposure on children and their families. ClinicalTrials.gov: NCT01726062.

German Public Support for Tobacco Control Policy Measures: Results from the German Study on Tobacco Use (DEBRA), a Representative National Survey.

Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”): a nationally representative, face-to-face household survey. Public support was measured on total ban of sale, raising the minimum age for sales, taxation of tobacco industry sales, research into e-cigarettes, and ban of smoking in cars when children are present. Associations were assessed with multivariate logistic regression. Over 50% of the German population support taxing industry profits (57.3%) and assessing e-cigarettes as an aid to quit smoking (55.5%). Over 40% support raising the legal age of sale (43.1%), and 22.9% support a total ban on tobacco sales. A smoking ban in cars when children are present was most popular (71.5%), even among current smokers (67.0%). There is public support for stricter tobacco control measures in Germany. A smoking ban in cars when children are present could be a feasible policy to implement.

The feasibility of an air purifier and secondhand smoke education intervention in homes of inner city pregnant women and infants living with a smoker

ObjectivesSecondhand smoke (SHS) and other air pollutants adversely affect the health of pregnant women and infants. A feasibility study aimed at reducing air pollution in homes of pregnant women or infants living with a smoker was completed. MethodsIn collaboration with the Baltimore City Health Department, women ≥ 18 years of age and either pregnant nonsmokers, or post-partum (any smoking status) with an infant age 0–12 months were recruited. Homes had at least one smoker. Intervention included two air purifiers and secondhand smoke education. Outcomes included feasibility, change in fine particulate matter (PM2.5), air nicotine, and salivary cotinine pre- and post-intervention. ResultsFifty women were enrolled (mean age 27 years, 92% African American, 71% single, 94% Medicaid eligible, 34% reported smoking) and 86% completed the study. Of the 50 women, 32 had infants and 18 were pregnant at time of enrollment. Post- intervention, 70% of participants reported smokers were less likely to smoke indoors, and 77% had at least one air purifier turned on at the final visit. Participant satisfaction was high (91%) and 98% would recommend air purifiers. Indoor PM2.5 was significantly decreased (P < 0.001). Salivary cotinine was significantly decreased for non-smoking women (P < 0.01) but not infants, and no significant change in air nicotine occurred (P = 0.6). ConclusionsAir purifiers with SHS education is a feasible intervention in homes of women and infants. These data demonstrate reduction in indoor PM2.5 and salivary cotinine in non-smoking adults. Air purifiers are not an alternative for smoking cessation and a home/ car smoking ban. Smoking cessation should be strongly encouraged for all pregnant women, and nonsmoking mothers with infants should be counseled to completely avoid SHS exposure. This study provides support for a future intervention evaluating clinical endpoints.

Smoke-free homes and attitudes towards banning smoking in vehicles carrying children in Spain (2016)

ObjectiveTo describe the voluntary adoption of smoke-free homes and social attitudes in Spain towards banning smoking in vehicles in which children are present. MethodsCross-sectional study of a representative sample of the adult Spanish population age range, 18–75 years (n=1036). The field work was conducted via a computer-assisted telephone survey in March and April 2016. Survey respondents answered questions about smoking rules at home and attitudes towards a smoking ban in cars with or without children. Home smoking rules were defined as complete (smoking not allowed anywhere in the house), partial (smoking allowed in some areas inside the house) or absent (smoking allowed everywhere). ResultsMost (83.0%) of the surveyed population had some type of smoking restriction in place at home (45.6% complete and 37.5% partial). There were significant differences between groups according to age group (the highest prevalence was 86.1% from 66 to 75 years and the lowest prevalence was 77.8% from 46 to 65 years) and smoking status (the highest prevalence was 89.4% in people who had never been smokers and the lowest prevalence was 75.0% in current smokers) with regards to the prevalence of smoke-free homes (p<0.05), with partial bans more prevalent in smoking households (49.0%). Most (61.6%) of the population favored banning smoking in cars, and 90.1% supported a ban in cars carrying minors. Attitudes towards smoking regulation in cars (with or without children) varied significantly by age group (the highest prevalence was 81.9% from 66 to 75 years and the lowest prevalence was 54.5% from 18 to 45 years) and smoking status (the highest prevalence was 71.4% in people who had never been smokers and the lowest prevalence was 46.0% in current smokers). However, no significant differences were found with regard to attitudes towards smoking regulation in cars carrying children, regardless of sex, age, social class, or smoking status. ConclusionApproximately half of the adult population in Spain have implemented a complete smoke-free rule at home. More than 9 out of 10 adults favor regulating smoking in cars in the presence of minors. These findings support the expansion of smoke-free regulations to include private vehicles, particularly when minors are in the car.

Smoking in Italy in 2015-2016: prevalence, trends, roll-your-own cigarettes, and attitudes towards incoming regulations.

In 2016, a series of selective tobacco regulations, which did not affect tobacco price, came into force in Italy. To understand how Italians accepted the new norms, we analyzed data from our 2 most recent surveys among those we annually conduct on tobacco. In 2015 and 2016, we conducted 2 representative cross-sectional studies focused on the new forthcoming tobacco legislation on a total sample of 6,046 Italians aged ≥15 years. Overall, 21.4% of Italians (26.0% of men and 17.2% of women) were current smokers, showing a small but significant decrease in smoking prevalence since 2007 (p for trend = 0.004). No change in smoking prevalence was observed over the last decade among the young (i.e., 15-24 years; 20.1% in 2015-2016). Roll-your-own cigarettes were the most frequent tobacco product for 8.3% of adult smokers and 19.7% of young smokers. According to the attitudes of Italians towards the new regulations, 91.3% supported the smoking ban in cars in presence of minors, 90.2% a more stringent enforcement of the tobacco sales-to-minors regulation, 74.3% the introduction of shocking pictorial images on tobacco packs, and 63.2% the removal from the market of small cigarette packs, usually purchased by the young. Smoking prevalence only marginally decreased over the last decade among adults, but did not decrease among the young. Roll-your-own tobacco is increasingly used by adults and young people. Before the entrance of the new norms, Italians largely supported them, particularly those targeting children.

Exploring smokers' opposition to proposed tobacco control strategies

Background Tobacco control (TC) advocates are searching for new TC strategies to decrease smoking rates further. Aims The aim of this study is to explore smokers' opposition to 16 TC strategies, including the attitudes in the sample as a whole. The results are discussed in relation to the importance of public versus smoker support, and the need for legitimate TC strategies. Methods An Internet panel with 35,000 registered users was accessed to invite participants to join a survey on attitudes towards TC strategies. In addition, 1253 participants were recruited directly from mobile phone lists. Of the 5543 participants recruited, 5250 adults aged 20 years or older were eligible for analysis. Respondents' attitudes were measured on a five-point Likert scale, and mean values, standard deviations and percentages of those who opposed TC regulations were reported. Results In the total sample, there was some support for regulating smoking in specific outdoors areas. Smokers opposed all of the proposed strategies except banning smoking in cars carrying children, increasing the age limit for purchasing cigarettes and banning smoking at transportation stops. Smokers seemed to accept regulations that protected others from the health risks of smoking, but defended their right to smoke in some specific outdoor areas. Conclusions Smokers opposed most of the proposed TC strategies. Smokers' support may be more important in TC areas that aim to denormalise smoking and where enforcement is more complex.

Understanding motivation to implement smoking bans among mothers with a hospitalized infant

ObjectiveSecondhand smoke exposure (SHSe) poses risks to hospitalized children upon discharge and no uniformly effective interventions have been identified. Understanding change-related processes and social-contextual factors related to motivation for implementing home and car smoking bans may inform interventions to reduce infant SHSe among mothers with a hospitalized infant. MethodsIn this cross-sectional, secondary analysis, mothers of neonatal ICU infants who reported smoking or living with a smoker (N=205) were assigned to stages of change (pre-contemplation, contemplation, preparation, or action) based on behaviors and intentions for establishing smoking bans in their homes and cars. Processes of change (POC) for SHSe reduction practices, self-efficacy, depressive symptoms, generalized anxiety, and social support for not smoking in the home were examined across all four stages. ResultsThe majority of mothers were in the action stage for having a home smoking ban in place (55%); only 35% of participants were in action for a car smoking ban. POC use differed across the stages of change for having a home ban (p=0.004) and car ban (p=0.02), with earlier stages using fewer overall and relatively fewer cognitive/affective processes. Earlier stage women also reported lower self-efficacy to change, less familial and partner support for in-home smoking bans, and more depressive symptoms. ConclusionsNovel intervention targets were identified, including cognitive/affective change processes, mental health, and familial/social contingencies for implementing SHSe protective practices. Creative ways in which to affect change at the individual and household level are needed in order to fully address the complexity of child SHSe.

A08 The evaluation of research impact on transport and health in five non-communicable disease areas as reported in a UK newspaper

BackgroundNewspaper reports of research on transport and health impact can influence ministers, senior officials, medical personnel, other researchers and the general public. This project explores the reporting of research activities in a widely-circulated UK newspaper, the Daily Mail, on various forms of transport and their effects on five non-communicable diseases (NCDs) namely oncology, cardiovascular diseases, diabetes, respiratory and mental disorders. MethodsThe Daily Mail was examined for articles citing research, i.e. peer-reviewed journal articles, from 2002 to 2013. In total 28,254 stories were retrieved from the online archive using a systematic search of keywords and these were screened for relevance. The keywords used were based upon a combination of 58 identified themes such as walking or diesel or train, with another four namely research, study, science and policy. In total 232 searches were performed under the health section of the e-archive. Data such as headline and journalist, details of the cited papers, any commentators and a brief synopsis were transferred to an Excel spreadsheet and the types of research and the NCDs affected were recorded by means of codes. After exclusion of personal stories not involving research, and of duplicates, a total of 300 studies fitted the inclusion criteria. Details of the cited papers were obtained from the Web of Science. These were then used for statistical analysis with a range of VBA macros. ResultsPreliminary analysis showed that a third of the stories were about the positive effects of walking and cycling on fitness, and hence on cardiovascular disease and diabetes. The other two-thirds were negative, and concerned the effects of noise and air pollution on mental health, respiratory diseases and cancer. Geographically, the USA dominated the cited research papers with 30%, followed by the UK (21%) and Canada (11%). These papers were very clinical and described the effects on health rather than basic research. ConclusionsTransport affects human health in positive and negative ways. For example, recent legislation (December 2014) that provides for a smoking ban in cars in the presence of children has been receiving repeated reporting in the press since 2009 by experts seeking to create this law. Transport policy can thus affect any of these five NCDs and influence individuals on making choices about using different forms of transport or choosing where they live.

Smoking ban in cars carrying children commended by the RCN

Smoking ban in cars carrying children commended by the RCN

Families at Risk: Home and Car Smoking Among Pregnant Women Attending a Low-Income, Urban Prenatal Clinic

Secondhand smoke exposure (SHSe) has been identified as a distinct risk factor for adverse obstetric and gynecological outcomes. This study examined the prevalence of SHSe reduction practices (i.e., home and car smoking bans) among pregnant women in a large U.S. prenatal clinic serving low-income women. Pregnant women (N = 820) attending a university-based, urban prenatal clinic in Houston, Texas, completed a prenatal questionnaire assessing bans on household and car smoking and a qualitative urine cotinine test as part of usual care. Data were collected from April 2011 to August 2012. Nearly one-third (n = 257) of the sample reported at least 1 smoker living in the home. About a quarter of the women in the full sample did not have a total smoking ban in their home and car. Within smoking households, 44% of the pregnant women reported smoking, 56% reported smoking by another household member, and in 26% of smoking households both the pregnant woman and at least one other person were smoking. Only 43% of women with a household smoker reported a total ban on smoking, with higher rates among Hispanic women. Smoking bans were less common when the pregnant women smoked, when more than 1 smoker resided in the home, and when pregnant with her first child. SHSe among low-income pregnant women is high, and interventions to raise awareness and increase the establishment of smoking bans in homes and cars are warranted.

MPs vote to introduce smoking ban in cars

MPs vote to introduce smoking ban in cars

Young people's exposure to and perceptions of smoking in cars and associated harms in the United Kingdom

Aims: To explore adolescents’ perceptions of smoking in cars and awareness of the potential harms associated with such exposure.Methods: Data were drawn from a 2011 cross-sectional study with 11–16 year olds (n = 1373) in the UK, who were asked how often they are exposed to smoking in cars, their support for banning smoking in cars and their perceptions of the harms associated with exposure, both to themselves and non-smokers in general.Findings: Almost half (46%) reported being exposed to smoking in cars, with 17% reporting travelling more than once a week with someone smoking. 85% supported a ban on smoking in cars carrying children under 16 years. 74% reported that they disliked being exposed to smoking in cars and 91% perceived exposure to be harmful. Logistic regression found that dislike of exposure, perceived harm and support for bans varied depending on smoking status, exposure to smoking in cars and their demographic profile.Conclusions: Many UK adolescents report exposure to smoking in cars. Adolescents’ opposition to such exposure, the associated health risks and their support for car smoking bans highlights the need for further consideration to be given to legislative options to protect children and others in private cars.

Public Opinion and Policy‐making

Abstract‘Evidence‐based policy’ often uses systematic reviews of existing research on the effectiveness of interventions to provide guidance for policymakers. When applied to gauging public support for interventions, there are two stumbling blocks – opinion data on contentious issues are volatile and prone to measurement error, and the barometer of public opinion should be set for the present rather than reflecting sentiments of other times. Despite these impediments, systematic reviews are a useful tool. Authoritative evidence to support policy is not a matter of taking contemporary, error‐free snapshots of public opinion but derives from building and testing explanation of how public attitudes arise. We make this case via a review of public support for legislation banning smoking in cars carrying children.

Pediatric Emergency Department Is a Promising Venue for Adult Tobacco Cessation Interventions

Pediatric Emergency Department Is a Promising Venue for Adult Tobacco Cessation Interventions

Smoking while driving and public support for car smoking bans in Italy

ObjectiveTo analyse the prevalence and correlates of smoking in cars as well as attitudes towards the extension of smoking bans in private vehicles among Italian adults.MethodsWe used data from two...

Join the drive to ban smoking in cars for our children’s sake

Join the drive to ban smoking in cars for our children’s sake

Join the drive to ban smoking in cars for our children’s sake

Join the drive to ban smoking in cars for our children’s sake