The 13th World Conference on Tobacco OR Health

Objective: To gain an in-depth understanding of the decision-making process families go through in adopting household smoking restrictions. Understanding the factors that facilitate and inhibit families from establishing and enforcing smoke-free homes will lead to more effective interventions, and ultimately, to reduced morbidity and mortality from secondhand smoke.

Methods: In-person, qualitative interviews were conducted with adult family members in 102 African American and white households in rural Georgia. Eligible households had at least one child aged 10-14 living in the home. Major themes were identified through standard qualitative analysis methods. Similarities and differences based on household members' smoking status and household ban status were also examined.

Results: In households where all of the adults smoked (n=40), family discussions about the need for a smoking ban focused very heavily on protecting children. When smoking bans were considered, it was often because a child in the home had asthma or bronchitis or that a doctor had recommended smoking restrictions to protect a child's health. Households with a mix of smoking and nonsmoking adults (n=39) reported these same reasons, but also discussed pressure from nonsmokers in the home who disliked being forced to breathe secondhand smoke. Nonsmoking households (n=23) were more likely to emphasize the dangers of secondhand smoke and comment that most of their family members and visitors were nonsmokers. The smell of secondhand smoke, discoloring of walls, buying a new home, having a baby, and living with a sick family member also motivated smoking restrictions in the home.