Secondhand smoke avoidance by preteens living with smokers: To leave or stay?

Abstract

Introduction-Secondhand smoke (SHS) is hazardous to children's health. Designing interventions to reduce exposure requires understanding children's behavior in the presence of smokers, yet little is known about this behavior.Purpose-To determine whether children's avoidance of SHS is associated with lower exposure and to explore predictors of avoidance based on a behavioral ecological model.Method-Preteens aged 8-13 (N=358) living with a smoker identified their primary source of SHS exposure, and reported whether they left (avoided exposure) or stayed the last time they were exposed to that person's smoke. The SHS avoidance measure was validated by examining associations with SHS exposure. Multivariable Logistic Regression was used to determine predictors of SHS avoidance.Results-Based on urine cotinine and reported exposure, preteens who left the presence of SHS had lower exposure than those who stayed. Preteens were more likely to leave SHS if they were less physically mature, had not tried smoking, had a firm commitment not to smoke, did not assist family smoking, had family/friends who discouraged breathing SHS, or had friends who disliked smoking.Discussion-Most SHS exposure reduction interventions have targeted changes in smokers' behavior. Reductions can also be achieved by changing exposed nonsmokers' behavior, such as avoiding the exposure. Future studies should measure young people's SHS avoidance and test interventions to increase their avoidance practices.

Exposure Evaluation of Environmental Tobacco Smoke: Gender and Socioeconomic Disparities in a Low Income Country-Palestine

“…Therefore, appropriate interventions programs to avoid exposure to ETS should be implemented in the Palestinian society as a whole where the impact would be very effective. This would further reverse the social inequalities and standards about smoking [31,32].…”

Accuracy and Concordance in Reporting for Secondhand Smoke Exposure among Adolescents Undergoing Treatment for Cancer and Their Parents

“…As adolescents experience an increased amount of control over their health decision making, 8 they have a greater role in preventing their personal SHSe by avoiding exposure or by actively demanding change to reduce their risk. Understanding SHSe reporting accuracy in adolescence is necessary for the next step in exposure reduction programs-interventions designed to enhance adolescents' exposure avoidance behavior.…”

“…The few studies that have examined accuracy of child-reported household SHSe suggest that children are generally accurate in identifying salient smoking-related risk factors (i.e., smoking status of adults living in the home), but are less accurate in reporting on duration of exposure and rates of smoking indoors 6 and may underreport exposure. 7 Adolescence is a period of autonomy seeking, marked by the development of personal health behaviors and attitudes, 8,9 and is a critical period for smoking-related risk behaviors 10,11 and adopting SHSe avoidance habits. Consequently, although the parents/guardians of adolescents typically provide reports of their children's SHSe, 12 adolescents themselves may be uniquely suited to report on SHSe.…”

Providing Coaching and Cotinine Results to Preteens to Reduce Their Secondhand Smoke Exposure

“…Baseline data collected in the current project indicated that preteens who avoided smokers had lower SHSe. 24 The purpose of the current trial, Project Sirocco, was to determine whether coaching, feedback and incentives provided to highrisk, ethnically diverse preteens residing in families with a smoker could reduce SHSe in their homes and cars.…”