• Academic pediatrics · Nov 2013

    Strict smoke-free home policies among smoking parents in pediatric settings.

    • Deborah J Ossip, Yuchiao Chang, Emara Nabi-Burza, Jeremy Drehmer, Stacia Finch, Bethany Hipple, Nancy A Rigotti, Jonathan D Klein, and Jonathan P Winickoff.
    • Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY. Electronic address: deborah_ossip@urmc.rochester.edu.
    • Acad Pediatr. 2013 Nov 1; 13 (6): 517-23.

    ObjectiveTo examine strict smoke-free home policies among smoking parents assessed in pediatric offices.MethodsWe analyzed baseline parental survey data from 10 control practices in a national trial of pediatric office-based tobacco control interventions (Clinical Effort Against Secondhand Smoke Exposure, CEASE). We used logistic regression models with generalized estimating equations to examine factors associated with strict smoke-free home policies.ResultsSubjects were 952 parents who were current smokers. Just over half (54.3%) reported strict smoke-free home policies. Few reported being asked (19.9%) or advised (17.1%) regarding policies by pediatricians. Factors associated with higher odds of policies were child 5 years or younger (adjusted odds ratio [aOR] 2.43, 95% confidence interval [CI] 1.53, 3.86), nonblack race/ethnicity (aORs 2.17-2.60, 95% CIs 1.25-5.00), non-Medicaid (HMO/private (aOR 1.84, 95% CI 1.31, 2.58); self-pay/other aOR 1.76, 95% CI 1.12, 2.78); well-child versus sick child visit (aOR 1.61, 95% CI 1.11, 2.34), fewer than 10 cigarettes per day (aOR 1.80, 95% CI 1.31, 2.47), no other home smokers (aOR 1.68, 95% CI 1.26, 2.25), only father smoking (aOR 1.73, 95% CI 1.06, 2.83), and strict smoke-free car policy (aOR 3.51, 95% CI 2.19, 5.64).ConclusionsNearly half of smoking parents did not have strict smoke-free home policies. Parents were less likely to report policies if they were heavier smokers, black, living with other smokers, or attending a sick child visit; if they did not have a young child or smoke-free car policy; if they had a child on Medicaid; and if anyone other than only the father smoked. Few pediatricians addressed or recommended strict smoke-free home policies in an office visit. The pediatric office encounter represents a currently missed opportunity to intervene regarding smoke-free homes, particularly for high-risk groups.Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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