Potential Unintended Consequences of Smoke-Free Policies in Public Places on Pregnant Women in China

Abstract

Background Smoke-free policies in public places have become more common in China. Little is known, however, about the potential unintended consequences of such policies on pregnant women. Methods The study was conducted in 2006 in Chengdu, China. Nonsmoking pregnant women (N = 55) whose husband were smokers participated in a study of their knowledge about secondhand smoke and smoke-free policies, their exposure to secondhand smoke, and their husbands’ smoking status at home. This study presents descriptive statistics, analyses based on family income and pregnant women’s education level, and the findings of focus group discussions that examined the potential unintended consequences of the smoke-free policies on pregnant women. Results Exposure to secondhand smoke at home was reported by 69.1% of the pregnant women. Both family income and the education level of the pregnant women had a significant (p < 0.05) association with exposure to secondhand smoke. The four main potential unintended consequences of the smoke-free policies were: (1) increased exposure of pregnant women to secondhand smoke at home; (2) reduced work efficiency; (3) adverse effect on family harmony; and (4) poor air quality at home. Conclusions Education is needed to increase knowledge of secondhand smoke among smokers and nonsmokers alike. When the smoking location is shifted from public places and workplaces to home, women, and in particular pregnant women, become the victims. Policymakers should recognize such potential unintended consequences and take necessary measures to increase awareness about the harms of secondhand smoke.

Effects of Enactment of Legislative (Public) Smoking Bans on Voluntary Home Smoking Restrictions: A Review

“…2,22,23,29,[34][35][36][37][38][39][40] Nevertheless, some findings suggest that smoking bans may have negative repercussions. 4,41,42 The relationships between private and public spaces with regard to smoking bans and behavior have been found to be complex and have been said to "demand[] more consideration if interventions in public areas are meant to serve as catalysts for favorable changes in primary private spaces such as homes." 20, p.2 This review aims to determine the overall effect of the enactment of legislative (public) smoking bans or restrictions on voluntary smoking restrictions in private residences as well as to evaluate the current status of the literature and the strength of evidence for and against diffusion and social displacement models.…”

“…In turn, private venues (eg, homes and cars) have generally replaced public spaces as the primary milieu of secondhand smoke (SHS) exposure. [3][4][5][6][7] The objective of this review has been to understand how the enactment of legislative (public) smoking bans or restrictions affect voluntary home smoking bans in private residences.…”

“…11 It has also long been known to be associated with adverse health effects for nonsmokers, such as cardiovascular disease, acute respiratory illness, low birth weight in babies of nonsmokers, morbidity and mortality in children, and multiple types of cancer. 4,[12][13][14] There is no safe level of SHS exposure, even minimal exposure to SHS is harmful. 8,15 The negative effects of smoking within the home go beyond the immediate health risks of exposure to SHS.…”

Effect of Media Campaigns and Smoke-Free Ordinance on Public Awareness and Secondhand Smoke Exposure in Taiwan

“…A study in China found that household SHS exposure increased after smoke-free policies were enacted because smokers shifted their smoking locations from public areas to home (Yao et al, 2009). However, most studies (Akhtar, Currie, Currie, & Haw, 2007;Galan et al, 2007;Haw & Gruer, 2007;Hyland et al, 2008;Ruprecht et al, 2006) have found no evidence of displacement of smoking from public places into the home after implementation of a smoke-free ordinance.…”

“…In addition, some studies have found unexpected consequences of a smoke-free policy, especially for disadvantaged populations. These consequences included an increase in SHS at home (Yao, Lee, & Mao, 2009) and a threat to female smokers' safety and public image when smoking on the street (Moore, Annechino, & Lee, 2009). As one part of a national evaluation, our study focused on assessing changes in public awareness and SHS exposure in the workplace and home after media campaigns and a smoke-free ordinance was implemented in Taiwan.…”