Reducing secondhand smoke exposure through training and policy change with home visiting programs

Issues: Smoking prevalence and secondhand smoke exposure is high among families with behavioral health concerns, lower socioeconomic status, and less education. For a variety of reasons, providers may lack the knowledge, confidence, and abilities to engage in conversations about tobacco with families. Additionally, while there are smoke-free workplace laws, agencies with home visiting workers do not commonly have policies or procedures to protect their employees from exposure to secondhand smoke. Description: The Institute for Health and Recovery's Smoke-Free Families Initiative program has been funded by Massachusetts Tobacco Cessation and Prevention Program since 2008 with the goal of integrating secondhand smoke awareness into home visits and other services to at-risk families. This goal is accomplished through 1) training staff how to intervene with families to reduce secondhand smoke exposure and 2) technical assistance to program directors to make policy and procedural change to support staff in this endeavor. Lessons Learned: Smoke-Free Families has trained over 1,900 staff in 61 programs. Our data suggests that trained staff are more 1) aware of the resources available which address reducing secondhand smoke and quitting tobacco use, 2) comfortable talking about secondhand smoke, and 3) likely to take advantage of opportunities to discuss tobacco with families. The majority of programs we have partnered with, including one statewide system, have adopted some policy or procedure change after receiving our training and consultation. Recommendations: Home visiting workers are a good population to train about secondhand smoke for their benefit and for the families with whom they work.