Home smoking restrictions before, during and after pregnancy—a qualitative study in rural China

Abstract

Worldwide, many nonsmokers (often women and children) are exposed to second-hand smoke (SHS) in home settings, as men retain their traditional power and control within their family and women and children have limited agency to intervene. This study, set up to explore home smoking management in rural China, found that some women were able to positively intervene to restrict men's smoking at three key stages: prior to conception, during their pregnancy and at the early years of their children's lives. By utilizing dominant social, health and political narratives about the importance of raising a healthy child supported by the One-Child Policy in China, combined with the fear of health risks of SHS to young children, the women were able to use their elevated status as bearer and carers of the only children to subvert the pre-eminence of men in domestic environments, enabling them to positively influence home smoking. While this study highlights the possibility for future smoking cessation initiatives in China by incorporating family carers' elevated awareness of protection of children's health in key stages of childhood, there is also a need for further health education, as family members were unsure why they needed to keep children smoke-free, which may partially explain why few households were smoke-free.

Smoking-Related Social Control in Indonesian Single-Smoker Couples

“…Studies among Chinese smokers have suggested that non-smoking wives have a limited influence on smoking cessation and report that smokers ignore their wives' interventions to make them stop smoking [20]. While the smokers accepted smoking restriction rules when their wives were pregnant [12], only a quarter quit smoking [21].…”

“…There have been very few studies in spousal social control in Asia. While a few qualitative studies have been conducted among Chinese smokers [12,37,38], to our knowledge, no other studies have been carried out in other Asian countries. The only Indonesian study by Nichter et al surveyed both husbands and wives of single-smoking couples about second-hand smoking exposure in their houses [23], however, social control was not the focus of the study.…”

Smoking Cessation Experience in Indonesia: Does the Non-smoking Wife Play a Role?

“…Additionally, in household settings, the space in which smoking fathers’ are allowed to smoke is often restricted due to considerations of morality and the desire to protect their child ( Oliffe et al, 2010 ), or a request from their wives ( Mao and Robinson, 2016 ). Spouses, specifically non-smoking ones, have been found to have a positive influence on smoking cessation.…”

“…Nevertheless, some studies conducted in China have shown how women managed to overcome the patriarchal barriers to exert their influence on smoking management at home, using their role as the health guardian of the family to this end ( Mao, 2013 , 2015 ; Mao and Robinson, 2016 ). They managed to restrict home smoking prior, during and after pregnancy ( Mao and Robinson, 2016 ), and joined forces with their mothers-in-law to gain more power at home ( Mao, 2015 ).…”

“…Nevertheless, some studies conducted in China have shown how women managed to overcome the patriarchal barriers to exert their influence on smoking management at home, using their role as the health guardian of the family to this end ( Mao, 2013 , 2015 ; Mao and Robinson, 2016 ). They managed to restrict home smoking prior, during and after pregnancy ( Mao and Robinson, 2016 ), and joined forces with their mothers-in-law to gain more power at home ( Mao, 2015 ). Similarly, in the case of the Indonesian women, those who felt powerless against their husbands’ smoking habit were on board with an initiative to create a community-wide ban and extensive campaigns against smoking inside the house that were sponsored by Quit Tobacco International and the Ministry of Health ( Nichter et al, 2010 ).…”