Interactions around smoke-free home policies and cessation: Results from a qualitative study of NYC families

Family dynamics are central in decision-making around smoking. Limited research has focused on understanding how families interact around smoking and the role smoking plays in households. However, understanding these complex interactions is crucial when developing anti-smoking materials and media used to motivate and support smokers' quit attempts. This qualitative study explored how family members encourage and discourage quit attempts, and the kinds of information they use to protect the family and limit household smoking. In 2007 and 2008, 36 in-depth interviews were conducted with seven families living in Harlem, a New York City neighborhood with high rates of adult smoking and childhood asthma. The findings indicate that: 1) Techniques to encourage cessation are utilized by families living with a smoker. Pro-active and passive approaches can convey the same message--that smokers' behavior is not accepted. 2) Smokers and their families employ harm reduction strategies that do and do not protect against the health effects of second-hand smoke exposure, such as smoking outside or near a window. 3) Although social support is cited in literature and by families as necessary during a quit attempt, it is often absent. 4) Smokers and non-smokers use anti-smoking commercials as a starting point for conversations about family members' smoking. These findings will enable the New York City Health Department to refine public messaging and interventions that resonate with smokers and their families, helping them to adopt smoke-free home policies to limit exposure to second-hand smoke and increase smoking cessation attempts.