Smoking In Cars Research Articles

Do European smokers opt for partial or total bans on smoking in homes and cars? Findings from the ITC 6 European country survey (EUREST-PLUS project)

Do European smokers opt for partial or total bans on smoking in homes and cars? Findings from the ITC 6 European country survey (EUREST-PLUS project)

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.

Do European smokers opt for partial or total bans on smoking in homes and cars? Findings from the ITC 6 European Country Survey (EUREST-PLUS Project)

Do European smokers opt for partial or total bans on smoking in homes and cars? Findings from the ITC 6 European Country Survey (EUREST-PLUS Project)

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.

Smoke-Free Car Legislation and Student Exposure to Smoking.

Policies protecting children from exposure to secondhand smoke (SHS) may help prevent SHS-related negative health outcomes in children and discourage them from intending to smoke in the future. In this study, we assess the impact of California's 2007 smoke-free vehicle law on changes in middle and high school students' reported exposure to smoking in cars. Secondary aims included assessing the association of student-reported exposure to smoking in vehicles and lifetime asthma diagnosis and future intentions to smoke. Population-weighted data from the California Student Tobacco Survey and the National Youth Tobacco Survey were used to evaluate California and national trends, respectively. Weighted logistic regression models using California Student Tobacco Survey 2011 data assessed the association between the number of days of exposure to smoking in cars and student-reported lifetime asthma diagnosis as well as intention to smoke in the future. The proportion of California students reporting exposure to smoking in cars in the last 7 days declined <1% annually from 2001 through 2005, but declined 12% annually from 2007 to 2011. National trends did not show comparable declines after 2006. Students reporting exposure to smoking in vehicles were more likely to report having ever been diagnosed with asthma and intending to smoke in the future than students who were not exposed to SHS. These findings support the legislative intent that public policies that are designed to protect children from exposure to smoking in vehicles will yield better adolescent health outcomes and a lower risk of future adolescent cigarette smoking.

Adult Attitudes and Practices Regarding Smoking Restrictions and Child Tobacco Smoke Exposure: 2000 to 2015.

Since 2000, tobacco control efforts have greatly increased state and local protections from childhood tobacco smoke exposure. The objective of this study is to examine changes in attitudes and practices regarding smoking bans in multiple public and private settings from 2000 to 2015, as well as to examine the changes in pediatrician and family practitioner screening and counseling for tobacco smoke exposure. Cross-sectional data from the annual Social Climate Survey of Tobacco Control were analyzed. The majority of adults, 69.3%, reported household smoking restrictions in 2000, and these restrictions increased to 79.5% through 2015 (P < .05). Car smoking prohibitions increased from 68.3% to 81.8% (P < .05). A growing majority of adults supports smoke-free policies in public settings, and tobacco counseling by child health care providers also increased. However, members of 1 in 5 households still permit smoking inside the home and family vehicle, and half of the US population is not protected by state or local laws prohibiting smoking inside of hospitality venues. Despite dramatic progress since 2000, these trend data reveal potential areas where child health care clinicians might focus effort at the family and community level to accelerate the protection of children from tobacco smoke exposure.

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.

Gender differences in risk factors for cigarette smoking initiation in childhood

IntroductionWe investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender. MethodsIn spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005–2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys. Results101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade. ConclusionsRisk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use.

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.

Right Here Right Now: Developing an understanding of responses to smoking policy developments using online data collection in near to real time

Right Here Right Now: Developing an understanding of responses to smoking policy developments using online data collection in near to real time

U.K. Bans Smoking in Cars with Children

U.K. Bans Smoking in Cars with Children

Frequency and risk factors related to smoking in cars with children present.

Second-hand smoke (SHS) can attain high concentrations in cars. To protect children's health, nine Canadian provinces have enacted legislation prohibiting smoking in privately owned vehicles when children are present; Quebec is the only province with no such legislation. The objective of this study was to estimate the proportion of smokers in Quebec who smoke while travelling in a private vehicle in which children are present, and to compare the characteristics of smokers who do and do not smoke in cars. In 2011-12, 754 daily smokers who recently travelled in a car with children completed a telephone survey in which they reported how frequently they smoked in a car, if there were smoking restrictions, and perceptions about the effectiveness of legislation prohibiting smoking in cars when children are present. Twenty-three percent of daily smokers smoked at least occasionally in their car when children were present. This proportion was higher among smokers who knew that there was no legislation in Quebec prohibiting smoking in cars, compared to smokers who believed that such legislation was already in effect (32% vs. 12%). Smokers with a university degree and those who reported that smoking was prohibited at home were less likely to expose children to SHS in cars. Most daily smokers (75%) believed that legislation would be effective. The results of this study suggest that legislation prohibiting smoking in cars is necessary to protect children from SHS, that such legislation would be effective, and that it may be relatively easy to implement.

Do provincial policies banning smoking in cars when children are present impact youth exposure to secondhand smoke in cars?

ObjectiveTo examine youth exposure to smoking in cars following 7 provincial bans on smoking in cars with children in Canada. MethodRepeated cross-sectional data from the 2004–2012 Youth Smoking Survey (n=91,800) were examined. Using a quasi-experimental design, contrasts of the interaction of survey year and province included in the logistic regression analyses were used to test whether exposure significantly declined pre-post implementation of a ban on smoking in cars relative to control provinces not implementing a ban. ResultsExposure across all provinces declined from 26.5% in 2004 to 18.2% of youth in 2012. Exposure declined significantly from pre to post implementation of a ban on smoking in cars with children in Ontario at time 1 post ban (Pre-Ban=20.4% T1post=10.3%, OR=0.45), time 2 post ban (12.1%, OR=0.61) and time 3 post ban (11.6%, OR=0.58) relative to control provinces that did not implement a ban. In British Columbia exposure to smoking in cars declined significantly at pre-post ban time 3 compared to the control group (Pre-Ban=21.2%, T3post=9.6%, OR=0.51). No other provinces had a significant change in exposure pre-post ban relative to the control provinces. InterpretationAlthough rates declined, significant differences were only found in Ontario relative to control provinces in the immediate and long term.

Second-hand smoke - ignored implications.

Second-hand smoke - ignored implications.

A systematic review of secondhand smoke exposure in a car: Attributable changes in atmospheric and biological markers.

Exposure to secondhand smoke (SHS) has been linked to disease, disability, and premature death. While several countries have enacted smoke-free legislations, exposure to SHS may still occur in unregulated private environments, such as in the family car. We performed a systematic review of peer-reviewed literature in PubMed and Web of Science up to May 2013. Articles were selected if they provided a quantitative measure of SHS exposure (biological or atmospheric markers); the study was conducted inside a car; and the assessed exposure was attributable to cigarette combustion. From 202 articles identified, 12 met the inclusion criteria. Among all studies that assessed smoking in cars with at least one window partially open, the particulate matter 2.5 μm or less in diameter (PM2.5) concentrations ranged from 47 μg/m(3) to 12,150 μg/m(3). For studies with all windows closed, PM2.5 ranged from 203.6 μg/m(3) to 13,150 μg/m(3). SHS concentration in a car was mediated by air-conditioning status, extent of airflow, and driving speed. Smoking in cars leads to extremely high exposure to SHS and increased concentration of atmospheric markers of exposure-even in the presence of air-conditioning or increased airflow from open windows. This clearly shows that the only way to protect nonsmokers, especially children, from SHS within cars is by eliminating tobacco smoking.

Ban on smoking in cars carrying children gains college support

Ban on smoking in cars carrying children gains college support

Prevalence of smoking restrictions and child exposure to secondhand smoke in cars and homes: a repeated cross-sectional survey of children aged 10–11 years in Wales

ObjectiveSmall increases in smoking restrictions in cars and homes were reported after legislation prohibiting smoking in public places. Few studies examine whether these changes continued in the longer term. This...

Portuguese children's exposure to second-hand tobacco smoke in the family car

ObjectivesTo assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. MethodsIn 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N=3187, mean age 9.5±0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. ResultsOf the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. ConclusionsChildren's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.