• Jeremy E Drehmer, Emara Nabi-Burza, Bethany Hipple Walters, Deborah J Ossip, Douglas E Levy, Nancy A Rigotti, Jonathan D Klein, and Jonathan P Winickoff.
• Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts.
• Pediatrics. 2019 Apr 1; 143 (4).

ObjectivesTo determine how smoke-free and vape-free home and car policies differ for parents who are dual users of cigarettes and electronic cigarettes (e-cigarettes), who only smoke cigarettes, or who only use e-cigarettes. To identify factors associated with not having smoke-free or vape-free policies and how often smoke-free advice is offered at pediatric offices.MethodsSecondary analysis of 2017 parental interview data collected after their children's visit in 5 control practices participating in the Clinical Effort Against Secondhand Smoke Exposure trial.ResultsMost dual users had smoke-free home policies, yet fewer had a vape-free home policies (63.8% vs 26.3%; P < .01). Dual users were less likely than cigarette users to have smoke-free car (P < .01), vape-free home (P < .001), or vape-free car (P < .001) policies. Inside cars, dual users were more likely than cigarette users to report smoking (P < .001), e-cigarette use (P < .001), and e-cigarette use with children present (P < .001). Parental characteristics associated with not having smoke-free or vape-free home and car policies include smoking ≥10 cigarettes per day, using e-cigarettes, and having a youngest child >10 years old. Smoke-free home and car advice was infrequently delivered.ConclusionsParents may perceive e-cigarette aerosol as safe for children. Dual users more often had smoke-free policies than vape-free policies for the home. Dual users were less likely than cigarette-only smokers to report various child-protective measures inside homes and cars. These findings reveal important opportunities for intervention with parents about smoking and vaping in homes and cars.Copyright © 2019 by the American Academy of Pediatrics.

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