Smoke-Free Homes and Home Exposure to Secondhand Smoke in Shanghai, China

Abstract

Few studies have examined home exposure to secondhand smoke (SHS) in China. This study aimed to document: (1) the prevalence and correlates of exposure to SHS in homes (in adult non-smokers) in Shanghai, and (2) enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8%) participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors.

“He Doesn’t Listen to My Words at All, So I Don’t Tell Him Anything”—A Qualitative Investigation on Exposure to Second Hand Smoke among Pregnant Women, Their Husbands and Family Members from Rural Bangladesh and Urban India

“…The sense of helplessness amongst the women was striking and this parallels the findings of studies from South and Southeast Asia which have similarly observed women’s inability to negotiate smoke free homes [21,22,25]. These authors attribute this to gender inequity and gendered power interactions.…”

“…SHS exposure is more among women from rural areas and those with low education. Studies done in Cambodia, China and India highlight women’s inability to negotiate smoke free homes [21,22]. This is true even when women are pregnant [22].…”

“…Studies done in Cambodia, China and India highlight women’s inability to negotiate smoke free homes [21,22]. This is true even when women are pregnant [22]. Factors such as lack of awareness, attitudes towards smoking, and cultural factors such as respect for elders that prevent negotiation, also lead to SHS exposure at home [14,15,16,17,23].…”

“…These include establishing and encouraging women to enforce smoke free home rules, enhancing their self-efficacy, increasing awareness, providing knowledge, changing attitudes and developing assertiveness skills [13,23]. A significant increase in knowledge, a change in attitude and an increase in assertiveness skills among pregnant women when exposed to SHS at home have been shown following these interventions [22,23]. The Trans-Theoretical Model and its stages of change may offer potential for informing interventions to prevent exposure to SHS [23].…”

Correlates of Allowing Alternative Tobacco Product or Marijuana Use in the Homes of Young Adults

“…This may be a reflection of cultural differences such that certain Asian American populations are particularly sensitive to accommodating guests or others present in their homes. 51–53 It is also interesting to note that being African American was associated with a greater likelihood of allowing hookah and marijuana use in the home in bivariate analyses, but these results did not hold in the regression models. In this sample, African Americans were more likely to be hookah and marijuana users, 45 so the regression results may have accounted for race via these variables.…”