“I can’t stand it…but I do it sometimes” parental smoking around children: practices, beliefs, and conflicts – a qualitative study

Abstract

Background Many parents continue to smoke around their children despite the widely known risks of children’s exposure to tobacco smoke. We sought to learn about parental smoking behavior around children from parents’ perspective. Methods Semi-structured interviews were conducted with 65 smoking parents or partners of smoking parents of children up to age 7, to learn about home smoking rules, behaviours performed to try to protect children, and smoking-related conflicts, from parents’ perspective. Interviews were recorded and transcribed and thematic analysis performed. Recruitment was challenging due to the sensitive nature of the topic. Results Many parents described smoking around their children in certain areas of the home, outdoors, and in what they consider to be open or ventilated areas. Participants emphasized efforts to protect their children and described various mitigating practices but held mixed views as to their effectiveness. Parents had different conceptions of which areas or distances were considered ‘safe’. Many smoking parents described conflicts both internal and with other family members regarding the protection of children. Some parents who continue to smoke around their children despite understanding the health risks felt powerless to effect change, as well as being uncertain as to the effectiveness of their protective strategies; others were aware but reluctant to change. Conclusion Findings shed light on some of the difficulties faced by smoking parents and obstacles to maintaining a smoke-free environment for their children, providing insight for the type of information and support required to help parents better protect their children from exposure to tobacco smoke. Awareness of health risks associated with secondhand smoke was demonstrated, yet parents in smoking families were confused regarding which rules and behaviours best protect children from exposure to tobacco smoke. Parents were sometimes aware that their smoking ‘rules’ and mitigating practices were limited in their effectiveness. Guidelines should be provided explaining how and when exposure occurs and how to keep children safe.

Trends in adolescent secondhand smoke exposure at home over 15 years in Korea: Inequality by parental education level

“…To reduce household SHS exposure, not only smoke-free home rules but also campaigns and community programs for parents are urgently needed to create social norms for smoke-free environments in society as a whole. Interviews with smoking Israeli parents with children aged <7 years revealed that the parents were aware of the health risks associated with SHS, but were confused about preventative methods and whether smoke-free home rules were effective 31 . Therefore, it is necessary to explain the need for smoke-free homes or to deliver the message via a campaign 31 .…”

“…Interviews with smoking Israeli parents with children aged <7 years revealed that the parents were aware of the health risks associated with SHS, but were confused about preventative methods and whether smoke-free home rules were effective 31 . Therefore, it is necessary to explain the need for smoke-free homes or to deliver the message via a campaign 31 . A randomized controlled trial on the effectiveness of household SHS interventions by community health workers found that smoking parents or caregivers with children, adopted complete smoking bans in China after the smoking hygiene intervention 32 .…”

Tobacco Smoke Exposure According to Location of Home Smoking in Israel: Findings from the Project Zero Exposure Study

“…Porch doors may often be left open in Israel’s climate, which is characterized by hot summers and mild winters. A qualitative study in Israel showed that some smoking parents described smoking on the balcony and leaving the door to the living room open [ 14 ]. Outdoor porches that are directly adjacent to the apartment may be small and completely enclosed, semi-enclosed, or open (see Supplemental Figure S4 ).…”

“…In our qualitative study of smoking parents in Israel, we found that parents in smoking families employed various strategies with different levels of restrictiveness, ranging from never permitting smoking inside or around the home, to smoking on the outside balcony with the door open or closed, to smoking only on an indoor balcony or designated areas in the home, to smoking “in” or at a window, or to smoking only when children are not present in the home. The parents themselves were often confused about the benefits of these strategies [ 13 , 14 ].…”