Smoke-free Cars Research Articles

Prevalence of Smoke-Free Car and Home Rules in Maine Before and After Passage of a Smoke-Free Vehicle Law, 2007–2010

IntroductionThis is the first study to examine the prevalence of self-reported smoke-free rules for private cars and homes before and after the passage of a smoke-free vehicle law.MethodsData were examined for 13,461 Maine adults aged 18 or older who participated in the Behavioral Risk Factor Surveillance System, a state-based telephone survey covering health topics. Self-reported smoke-free car and home rules, smoking behavior, and demographic variables of age, sex, education, income, and children in household were analyzed for prevalence before and after the state’s smoke-free vehicle law was passed.ResultsPrevalence of smoke-free car and home rules was significantly higher after Maine’s smoke-free vehicle law was passed in the state (P = .004 for car rules and P = .009 for home rules). Variations in smoking rules differed by smoking and demographic variables. People with household incomes of less than $20,000 saw an increase of 14.3% in smoke-free car rules; overall, those with annual incomes of less than $20,000 and those with less than a high school education reported a lower prevalence of smoke-free car rules both before and after the law was passed than did people with higher incomes and higher education levels. The prevalence of smoke-free home rules after the law was implemented was higher among those with 4 or more years of college education than among those with lower levels of education (P = .02).ConclusionThe prevalence of smoke-free car and home rules among Maine adults was significantly higher after the passage of a statewide smoke-free vehicle law. This apparent change in smoke-free rule prevalence may be indicative of changing social norms related to the unacceptability of secondhand smoke exposure.

Association between clean indoor air laws and voluntary smokefree rules in homes and cars

ObjectivesThis study examines the influence that smokefree workplaces, restaurants and bars have on the adoption of smokefree rules in homes and cars, and whether there is an association with adopting...

“Nobody smokes in the house if there's a new baby in it”: Aboriginal perspectives on tobacco smoking in pregnancy and in the household in regional NSW Australia

Smoking prevalence in Aboriginal and Torres Strait Islander pregnant women is quadruple that of non-Indigenous counterparts, impacting on the health of babies and children. To explore attitudes and experiences related to prenatal tobacco smoking by Aboriginal women and household smoking, and to provide recommendations for culturally appropriate interventions. We conducted five focus groups with clients and family members of a regional NSW Aboriginal maternity service (n=18). Committees, including Aboriginal representatives, oversaw the study. We analysed transcripts with the constant comparative method and developed key categories. Categories included: social and family influences, knowing and experiencing the health effects of smoking, responses to health messages, cravings and stress, giving up and cutting down, managing smoke-free homes and cars, and community recommendations. Smoking in pregnancy and passive smoking were acknowledged as harmful for babies and children. Anti-tobacco messages and cessation advice appeared more salient when concordant with women's lived experience. Reduced cigarette consumption was reported in pregnancy. Despite smoking in the home, families were engaged in the management of environmental tobacco smoke to reduce harm to babies and children. Abstinence was difficult to initiate or maintain with the widespread use of tobacco in the social and family realm. Anti-tobacco messages and interventions should relate to Aboriginal women's experiences, improve understanding of the quitting process, support efficacy, and capitalise on the positive changes occurring in smoke-free home management. Focus group participants recommended individual, group and family approaches, and access to cessation services and nicotine replacement therapy for Aboriginal pregnant women who smoke.

The “Don't Smoke in Our Home” Randomized Controlled Trial to Protect Children from Second-Hand Smoke Exposure at Home

Increasing smoke-free homes is an important public health goal, but only few interventions have yielded positive results. The aim of the "Don't smoke in our home" trial was to evaluate a counseling intervention focused on promoting totally smoke-free homes and cars (TSFHC) delivered to women with children resident in four Tuscan towns. We used a two-group randomized controlled trial design. Participants were asked about their smoking habits and about restrictions on smoking in their homes and cars. All women received a self-help booklet promoting TSFHC, and 110 women randomized to the intervention also attended brief counseling on second-hand smoke exposure protection and received three gifts to remember the commitment to TSFHC. Follow-up was conducted by phone after four months. We recruited 218 women, 64 of whom had a university degree and 131 of whom were smokers; 62% reported smoking indoors and 58% in cars. Before the intervention, nonsmokers were more likely to report totally smoke-free homes (TSFH, 52%) and cars (TSFC, 53%) than smokers (26% and 17% respectively; P <0.001). Participants of the experimental arm had similar odds as controls of having implemented TSFH after the intervention, and nonsignificantly increased odds of having introduced TSFC (odds ratio [OR] 1.47; 95% confidence interval [CI] 0.69-3.11), particularly among smokers (OR 2.24, 95%CI 0.69-7.26). All participants independently of the study arm recorded significant increases of 12 and 15 percentage points in TSFH and TSFC, respectively. Few smokers quit smoking (7%), stopped smoking indoors (5%), and stopped smoking in cars (7%), with no differences between the intervention and control groups. Adding brief counseling to written materials did not significantly increase TSFHC. However, delivering written materials only may produce modest but noteworthy TSFHC increases at the population level, even though the participants in the study did not represent a population-based sample, given the high proportion of highly educated women. Further studies are required to confirm these results.

Parents smoking in their cars with children present.

To determine prevalence and factors associated with strictly enforced smoke-free car policies among smoking parents. As part of a cluster, randomized controlled trial addressing parental smoking, exit interviews were conducted with parents whose children were seen in 10 control pediatric practices. Parents who smoked were asked about smoking behaviors in their car and receipt of smoke-free car advice at the visit. Parents were considered to have a "strictly enforced smoke-free car policy" if they reported having a smoke-free car policy and nobody had smoked in their car within the past 3 months. Of 981 smoking parents, 817 (83%) had a car; of these, 795 parents answered questions about their car smoking policy. Of these 795 parents, 29% reported having a smoke-free car policy, and 24% had a strictly enforced smoke-free car policy. Of the 562 parents without a smoke-free car policy, 48% reported that smoking occurred with children present. Few parents who smoke (12%) were advised to have a smoke-free car. Multivariable logistic regression controlling for parent age, gender, education, and race showed that having a younger child and smoking ≤10 cigarettes per day were associated with having a strictly enforced smoke-free car policy. The majority of smoking parents exposed their children to tobacco smoke in cars. Coupled with the finding of low rates of pediatricians addressing smoking in cars, this study highlights the need for improved pediatric interventions, public health campaigns, and policies regarding smoke-free car laws to protect children from tobacco smoke.

Pediatrician Interventions and Thirdhand Smoke Beliefs of Parents

Thirdhand smoke is residual tobacco smoke contamination that remains after a cigarette is extinguished. A national study indicates that adults' belief that thirdhand smoke (THS) harms children is associated with strict household no-smoking policies. The question of whether pediatricians can influence THS beliefs has not been assessed. To identify prevalence of THS beliefs and associated factors among smoking parents, and the association of pediatrician intervention on parent belief that THS is harmful to their children. Exit interview data were collected from 1980 parents following a pediatric office visit. Parents' level of agreement or disagreement that THS can harm the health of babies and children was assessed. A multivariate logistic regression model was constructed to identify whether pediatricians' actions were independently associated with parental belief that THS can harm the health of babies and children. Data were collected from 2009 to 2011, and analyses were conducted in 2012. Ninety-one percent of parents believed that THS can harm the health of babies and children. Fathers (AOR=0.59, 95% CI=0.42, 0.84) and parents who smoked more than ten cigarettes per day (AOR=0.63, 95% CI=0.45, 0.88) were less likely to agree with this statement. In contrast, parents who received advice (AOR=1.60, 95% CI=1.04, 2.45) to have a smokefree home or car or to quit smoking and parents who were referred (AOR=3.42, 95% CI=1.18, 9.94) to a "quitline" or other cessation program were more likely to agree that THS can be harmful. Fathers and heavier smokers were less likely to believe that THS is harmful. However, pediatricians' actions to encourage smoking parents to quit or adopt smokefree home or car policies were associated with parental beliefs that THS harms children. This study is registered at NCT00664261.

Commentary on Sims et al. (2012): A timely response to the impact of smoke‐free public places on the most exposed children

.[4] provide timely evidence that smoke-free legislationdoes not displace adult smoking to the home, but ratherreduces SHS exposure among most at risk children, i.e.those with smoking parents or living in homes allow-ing smoking. These findings dispute the arguments andinform health advocates and policymakers about theunintended health benefits of protecting non-smokers,especially children exposed to second-hand smoke in thehome [5]. Given that the main source of SHS exposureamong children is domestic [6,7], the reported declinesreflect changing social norms around smoking [8],perhaps derived from voluntary family-based restrictionsby adults to promote health in children [6].Children are particularly vulnerable to SHS exposure,as even modest levels of exposure have been associatedwith respiratory abnormalities and other adverse healtheffects [9,10]. As adolescents observe smoking in thedomestic setting, they tend more towards seeing smokingas normal adult behaviour, and attribute favourableoutcome expectations over time with repeated exposure[8,11]. Research has shown that adolescent adoption ofsmoking is related to perceptions of significant others,such as parental smoking behaviour, as well as societalnorms of smoking [12,13]. In an environment where anon-smoking directive, e.g. smoke-free homes or cars, isenacted children will possibly perceive smoking as asocially unacceptable behaviour, and may be less likely totake up smoking [14]. However, despite reported declinesin SHS exposure by the authors, the high levels of chil-dren’s exposure in England (approximately half livingin homes allowing smoking and a third with smokingparents) may send an unequivocal message to youthsthat smoking is still a normative behaviour, and mightsensitize them to start smoking.Sims

Public support for smoke-free areas in Israel: A case for action

ObjectiveSecondhand smoke exposure (SHSe) harms adults and children. Though most governments are obliged by international health treaty to protect nonsmokers from SHSe, few adequately do so. Public opinion can provide a powerful mandate for smoke-free policies, but a representative public voice is often absent from the political discussion. For example, following Cabinet approval of a national tobacco control plan, Israel remains embroiled in stormy debate about smoke-free legislation. This debate has unfolded without benefit of current empirical evidence on nationwide public support. The present study reports and assesses public opinion regarding smoke-free places. MethodsA nationally representative survey (n=505) was conducted in December, 2010. The response rate was 61%. ResultsPublic opinion supports smoke-free air in many places. There was broad consensus among current, former, and never-smokers for smoke-free cars carrying children (94.4%), and smoke-free healthcare facility entrances (92.6%). A clear majority (67.0%) supportedcompletely smoke-free bars and pubs. Nearly half (47.3%) supported eliminating school staff smoking rooms. ConclusionsThese data strengthen the case for the recent government-approved tobacco control plan. Valid data regarding public opinion on tobacco control can facilitate passage and implementation of smoke-free legislation, thus speeding transition to smoke-free societies.

Protecting the Vulnerable: The Importance of Effective Parental Tobacco-Dependence Treatment During Prenatal and Newborn Care.

Tobacco use among pregnant women, as well as second- and third-hand smoke exposure of their infants, translates into the startling fact that more than one third of American children live with at least one parent who smokes cigarettes daily. Maternal smoking or second-hand smoke exposure during pregnancy is deleterious to the mother's health and contributes to prematurity, low birth-weight infants, and increased risk of sudden infant death syndrome (SIDS) and recurrent wheezing during the first year of life. Pregnant women who stop tobacco use during pregnancy are at high risk for postpartum relapse frequently associated with a partner who smokes tobacco, stress, poverty, and lack of social and medical support to remain tobacco free. Enhanced efforts to identify and support pregnant women who smoke, and to implement strategies to prevent exposure of their fetus and newborn to the hazards of tobacco-smoke exposure, are paramount in our public health efforts to eliminate health disparities in the United States. We discuss the critical elements of programs to assist mothers to stop smoking during pregnancy and toward family efforts to maintain a smoke-free environment for their infant. Postpartum interventions, whether in the neonatal intensive care unit (NICU), newborn nursery, or postnatal care setting, can provide assistance that women need to remain smoke free, to educate spouses or significant others and their families, and to aide in establishing goals of maintaining a tobacco smoke-free home and car. Physicians and other perinatal healthcare providers have a duty to identify pregnant women who smoke for "meaningful use" in the electronic medical record, and to provide advice and assistance in evidence-based smoking interventions in obstetrical care settings. Pediatricians, neonatologists, and others providing postpartum, "normal" nursery or NICU care have an opportunity to protect infants and young children from second- and third-hand smoke exposure by assisting their parents and family members in maintaining a tobacco-free environment to improve the health of infants, toddlers, and young children.

Towards smoke-free rental cars: an evaluation of voluntary smoking restrictions in California

IntroductionSome car rental companies in California and other states in the USA have established non-smoking policies for their vehicles. This study examined the effectiveness of these policies in maintaining smoke-free...

Predictors of car smoking rules among smokers in France, Germany and the Netherlands

As exposure to tobacco smoke pollution (TSP) has been identified as a cause of premature death and disease in non-smokers, and studies have demonstrated that smoking in cars produces high levels of TSP, this study will investigate smokers' rules for smoking in their cars, and predictors of car smoking rules, including potentially modifiable correlates. Data were drawn from nationally representative samples of current smokers from the International Tobacco Control Policy Evaluation Project surveys in France (2007), Germany (2007), and the Netherlands (2008). Smokers in France and Germany were asked about smoking rules in their cars, and smokers in the Netherlands were asked about smoking rules in cars carrying children. In France and Germany, 59% and 52% of smokers respectively, allowed smoking in their cars. In the Netherlands, 36% of smokers allowed smoking in cars carrying children. Predictors of allowing smoking in cars included: being a daily vs. non-daily smoker, being younger vs. older age, having no (young) children in the home, being a heavier smoker, and allowing smoking in the home. In the Netherlands, smokers who agreed that TSP is dangerous to non-smokers were less likely to allow smoking in cars carrying children. Overall, a sizeable proportion of smokers allowed smoking in their cars across the three countries. Media campaigns with information about the dangers of TSP may increase the adoption of smoke-free cars. These media campaigns could target smokers who are most likely to allow smoking in cars.

South African College Students’ Attitudes Regarding Smoke-Free Policies in Public, on Campus, and in Private Spaces

Background: Despite the increase in smoke-free policies globally, there has been limited research regarding reactions to them among young adults. Thus, the objectives of the current study are to examine smoking behaviors and attitudes toward smoke-free policies among South African college students. Design and Methods: In Summer 2010, University of Cape Town students were recruited for surveys and focus groups through fliers and classroom announcements. Survey assessments included sociodemographics, smoking behaviors, and attitudes toward smoke-free policies. The online survey was completed by 103 college students, and 4 focus groups among 27 college smokers were conducted. Results: Of 103 survey participants, 41.7% (n=43) were current (past 30-day) smokers. Correlates of current smoking included being male (OR=0.32, p=.020), having more friends that smoke (OR=1.32, p=.031), more frequently consuming alcohol (OR=1.07, p=.060), and having used marijuana in the past 30 days (OR=3.75, p=.029). Participants reported high levels of approval of smoke-free policies in public (93.2%) and on campus (60.2%) and frequently implemented smoke-free policies in their homes (67.0%) and cars (73.8%). Correlates of receptivity to public policies included not living with smokers (p=.020) and being nonsmokers (p=.003). Receptivity to a smoke-free campus was associated with fewer friends who smoke (p=.022), having nonsmoking parents (p=.014), and being nonsmokers (p<.001). Correlates of having a smoke-free home included not using alcohol in the past 30 days (p=.053), having nonsmoking parents (p=.024), and not living with smokers (p<.001). Having a smoke-free car was associated with not recently using alcohol (p=.002), living on campus (p=.037), and being nonsmokers (p=.009). Focus group data indicated that, despite support for smoke-free policies, enforcement of public and campus policies is limited. Conclusions: Future tobacco control efforts might focus cessation among young adults and enforcement of existing public and campus policies in South Africa.

Physician advice on avoiding secondhand smoke exposure and referrals for smoking cessation services

BackgroundSecondhand smoke (SHS) exposure causes premature death and disease. Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from SHS exposure, and also contributes to helping smokers quit smoking. Primary health care providers can play an important role in advising nonsmoking patients to avoid SHS exposure, cautioning current smokers against exposing others to SHS, and referring tobacco users to cessation programs.MethodsThe purpose of this paper is to examine primary care provider (obstetricians/gynecologists, pediatricians, and general practitioners) advice regarding SHS exposure and referral to cessation programs. Using data from the 2008 DocStyles survey (n = 1,454), we calculated the prevalence and adjusted odds ratios for offering patients advice regarding SHS exposure and referring adults who smoked or used other tobacco products to a cessation program.ResultsThe current study found that among a convenience sample of primary care providers, 94.9% encouraged parents to take steps to protect children from SHS exposure, 86.1% encouraged smokers to make their homes and cars smoke-free, and 77.4% encouraged nonsmokers to avoid SHS exposure. Approximately 44.0% of primary care providers usually or always referred patients who smoked or used tobacco products to cessation programs such as a quitline, a group cessation class, or one-on-one counseling.ConclusionFindings from a convenience sample of primary care providers who participated in a web-based survey, suggests that many primary care providers are advising parents to protect children from SHS exposure, encouraging patients who smoke to maintain smoke-free homes and cars, and advising smokers on ways to avoid exposing others to SHS. Healthcare providers are encouraged to advise patients to avoid SHS exposure and to refer patients who use tobacco products to cessation services.

‘Balancing acts’: The politics and processes of smokefree area policymaking in a small state

To examine the influences on contemporary smokefree area policy development in New Zealand. Semi-structured interviews were conducted with 62 New Zealand politicians and senior officials. They were asked about their views of possible interventions to reduce smoking around children, and how to achieve progress on smokefree homes, cars and public places. Transcribed data were analysed for themes, some of which were determined by the questions asked, and some emerged from the dynamic nature of the interviews. Policymaking for smokefree areas was seen by participants as a complex, highly politicised activity, concerned with balancing a number of factors including evidence, personal experience, concern for smokers, and the desire for public support for policy. The majority of participants were cautious about making substantive policy moves on smokefree places because of their perception of the issue as highly controversial, their wish to avoid public resistance and their desire for community engagement. Preference was shown for a policy approach based on persuasion rather than legislation, as a means to make progress on smokefree cars and outdoor spaces. The results indicate the need for good communication of the acceptability and benefits of legislative smokefree changes to both the political and public arena.

What is behind smoker support for new smokefree areas? National survey data

BackgroundSome countries have started to extend indoor smokefree laws to cover cars and various outdoor settings. However, policy-modifiable factors around smoker support for these new laws are not well described.MethodsThe New Zealand (NZ) arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) derives its sample from the NZ Health Survey (a national sample). From this sample we surveyed adult smokers (n = 1376).ResultsFor the six settings considered, 59% of smokers supported at least three new completely smokefree areas. Only 2% favoured smoking being allowed in all the six new settings. Support among Maori, Pacific and Asian smokers relative to European smokers was elevated in multivariate analyses, but confidence intervals often included 1.0.Also in the multivariate analyses, "strong support" by smokers for new smokefree area laws was associated with greater knowledge of the second-hand smoke (SHS) hazard, and with behaviours to reduce SHS exposure towards others. Strong support was also associated with reporting having smokefree cars (aOR = 1.68, 95% CI = 1.21 - 2.34); and support for tobacco control regulatory measures by government (aOR = 1.63, 95% CI = 1.32 - 2.01). There was also stronger support by smokers with a form of financial stress (not spending on household essentials).ConclusionsSmokers from a range of population groups can show majority support for new outdoor and smokefree car laws. Some of these findings are consistent with the use of public health strategies to support new smokefree laws, such as enhancing public knowledge of the second-hand smoke hazard.

A qualitative case study of policy maker views about the protection of children from smoking in cars

As little is known about the policy making process around smokefree car laws, we aimed to investigate policy makers' views about such laws in a setting where these have not yet been enacted but where published evidence exists on the hazard of smoking in cars and on relevant public support. A New Zealand (NZ) case study (of the NZ health policy community) used documents and qualitative in-depth interviews with 62 national-level and District Health Board (DHB)-level policy makers (during 2008-2009). Forty were government or nongovernmental organization officials, 5 DHB board members, and 17 Members of Parliament. We found very strong themes of policy maker concern for the vulnerability of children and the need for their protection from secondhand smoke. There were mixed reactions to the idea of a smokefree law for cars with children in them. These themes and mixed reactions spanned both the "left" and "right" political parties. The evidence indicates that smokefree car laws are only barely on the NZ national policy making agenda. They are generally not seen as politically attractive, as effective, or easy to implement. In this particular policy setting, there appear to have been assumptions by policy makers about the dominance of adult "privacy" over child protection. The lack of awareness in this particular (NZ) policy community of national-level public support for banning smoking in cars with children and of the progress elsewhere on such laws also suggests the importance of information and advocacy if such laws are to be progressed.

Predictors of smoking in cars with nonsmokers: Findings from the 2007 Wave of the International Tobacco Control Four Country Survey

This study examines the proportion and characteristics of smokers who smoke in cars with nonsmokers across four countries and the potentially modifiable correlates of this behavior. Respondents included a total of 6,786 current adult smokers from Wave 6 (September 2007-February 2008) of the International Tobacco Control Four Country Survey, a random digit-dial telephone survey of nationally representative samples of adult smokers in Australia, the United Kingdom, Canada, and the United States. Reports of smoking in cars with nonsmokers ranged from a low of 29% in Australia and the United Kingdom, to 34% in Canada, and to a high of 44% in the United States. Daily smokers who were from the United States, male, and younger were the most likely to smoke in cars with nonsmokers. Several potentially modifiable factors were also found to be related to this behavior, including smoke-free homes and beliefs about the dangers of cigarette smoke exposure to nonsmokers. A considerable proportion of smokers continue to smoke in cars with nonsmokers across the four countries, particularly in the United States. Public health campaigns should educate smokers about the hazards of cigarette smoke exposure and promote the need for smoke-free cars. These findings provide a foundation of evidence relevant for jurisdictions that are considering banning smoking in cars.

Exposure to Particulate Matter in Vehicle Cabins of Private Cars

A growing number of studies indicate the significance of short-term exposures to airborne particulate matter, such as those occurring in a vehicle cabin. In this study, PM10, PM2.5, PM1 concentrations were measured using optical particle counters in eighteen tobacco smoke-free private cars in movement. The average concentrations were 48.6 µg/m3, 26.9 µg/m3 and 22.6 µg/m3 for PM10, PM2.5 and for PM1, respectively. These levels were found to depend directly on the ambient air PM concentration and the choice of ventilation used inside the cars. The average number of particles with a diameter > 0.3 µm measured in the cabins of the cars was 185,723 particles/L. The average number of particles with a diameter between 0.02–1 µm was 16,391 particles/cm3. Concentrations were found to partly exceed the established limit values for ambient air. Thus, the time spent driving a vehicle might significantly contribute to the daily overall exposure to particulate matter, especially in the case of some groups of professional workers.

A qualitative study on establishing and enforcing smoking rules in family cars

With continued expansion of clean indoor air legislation, private spaces such as homes and cars are gaining increased attention as significant sources of secondhand smoke (SHS). This study examines the establishment and enforcement of smoking rules in family cars. Qualitative interviews (N = 136) were conducted with Black and White families in rural Georgia. Participating families had a young adolescent in the home and included households with all nonsmokers, a mix of smokers and nonsmokers, and all smokers. Common car smoking rules included no smoking allowed at any time, smoking allowed if a window is cracked, and no smoking allowed if children or nonsmokers are in the car. Major reasons for rules included protecting children and nonsmokers from SHS, aversion to the smell, and the stifling nature of SHS in cars. Damage to the vehicle from ashes and burns was another reason for smoking rules, particularly among families with smokers. Many families had never discussed car smoking rules. Families with car smoking rules were generally able to enforce them without difficulty, although smokers responded with a range of reactions from acceptance to anger. Families would consider a total ban if the smoker in their family quit or, for a few, if they purchased a new car. These findings have implications for designing intervention strategies to promote smoke-free cars and help family members to negotiate and enforce car smoking rules.

Banning smoking in cars carrying children: an analytical history of a public health advocacy campaign

Framing public health policy reform in ways that attract public and political support is a core skill of advocacy. In this paper we summarise the 12-year Australian history of advocacy for banning smoking in cars carrying children, culminating in the governments of the Australian States of South Australia and Tasmania enacting legislation. 'Smoking in cars' was searched on the factiva.com print news media database, with returns limited to Australian newspapers published before 1 June 2007. The issue of smoking in cars received extensive and emotive media coverage, primarily in support of legislating a ban. Invoking the protection of vulnerable children in the debate about smoking in cars was a powerful and persuasive theme. Unlike all other advocacy for smoke-free areas, this debate was not contested by the tobacco industry or other commercial interest groups. Even in the absence of a co-ordinated advocacy campaign, public opinion studies on support for such legislation have been consistently strong. Communities view the protection of children as paramount and non-negotiable. Smoke-free cars legislation can and should be fast tracked in order to capitalise on this community support.