Prevalence and correlates of different smoking bans in homes and cars among smokers in 6 Countries of the EUREST-PLUS ITC Europe Surveys

Abstract

INTRODUCTION Second-hand smoke exposure has decreased in a number of countries due to widespread smoke-free legislation in public places, but exposure is still present in private settings like homes and cars. Our objective was to describe to what extent smokers implement smoking rules in these settings in six European Union (EU) Member States (MS). METHODS A cross-sectional survey was conducted with a nationally representative sample of adult smokers from Germany, Greece, Hungary, Poland, Romania and Spain (ITC six European countries survey, part of the EUREST-PLUS Project). We analysed data from 6011 smokers regarding smoking rules in their homes and in cars with children (no rules, partial ban, total ban). We described the prevalence of smoking rules by EU MS and several sociodemographic and smoking characteristics using prevalence ratios (PR) and 95% confidence intervals (CI) derived from Poisson regression models. \ RESULTS In homes, 26.5% had a total smoking ban (from 13.1% in Spain to 35.5% in Hungary), 44.7% had a partial ban (from 41.3% in Spain to 49.9% in Greece), and 28.8% had no-smoking rules (from 20.2% in Romania to 45.6% in Spain). Prevalence of no-smoking rules in cars with children was 16.2% (from 11.2% in Germany to 20.4% in Spain). The correlates of not restricting smoking in homes and cars included: low education (PR=1.51; 95%CI: 1.20-1.90 and PR=1.55; 95%CI: 1.09-2.20), smoking >30 cigarettes daily (PR=1.53; 95%CI: 1.10-2.14 and PR=2.66; 95%CI: 1.40-5.05) and no attempts to quit ever (PR=1.18; 95%CI: 1.06-1.31 and PR=1.28; 95%CI: 1.06-1.54). CONCLUSIONS Among smokers in six EU MS, no-smoking rules were more prevalent in homes than in cars with children. Whilst awareness about the health effects of exposure to tobacco smoke on children seemed to be high, more research is needed to better understand the factors that promote private smoke-free environments.

Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey

“…This finding is reflected in data on home smoking rule adoption rates across the EU [ 29 , 30 ]. According to the EUREST-PLUS Project, which includes six EU countries [ 29 ], the proportion of 100% smoke-free homes among smokers in 2016 varied from 13.1% in Spain to 35.5% in Hungary [ 29 ]. In our study, a full smoke-free home rule was reported by 18.6% of smokers, which is almost half the rate observed in Hungary [ 28 ].…”

“…While the prevalence of total smoke-free home rules among non-smokers increased by 59% (from 50.2% to 79.8%) between 2010 to 2019, the prevalence among smokers increased by just 18.5% (from 15.7% to 18.6%) [28]. This finding is reflected in data on home smoking rule adoption rates across the EU [29,30]. According to the EUREST-PLUS Project, which includes six EU countries [29], the proportion of 100% smoke-free homes among smokers in 2016 varied from 13.1% in Spain to 35.5% in Hungary [29].…”

The support of young adults for the smoking ban in public places in Poland – a qualitative study

“…The situation in selected 6 European countries (Germany, Greece, Hungary, Poland, Romania, and Spain) related to the privately applicable rules on smoking in lower areas was analysed, despite the generally non-binding smoking ban. The results of the study indicated that 1/4 of smokers introduced a voluntary ban on smoking at home and 2/3 in cars in the presence of children [23].…”

Factors Related to a Smoke-free Home Status: A Parental Report

“…The prevalence of homes without a smoke-free rule was reported at 88.5% (Antunes et al, 2016). In Europe, the prevalence varied from 20.2% in Romania to 45.6% in Spain (Fu et al, 2018). Such a difference in prevalence might be due to differences in population and study sample.…”