Development of Clean Indoor Air Policies Among New Mothers: What Matters?

Background: Establishing clean indoor air (CIA) policies in the home may reduce children's exposure to secondhand smoke (SHS). However, there may be challenges to developing a CIA policy, particularly among low-income smokers. This study assessed the existence of CIA home policies in a cross-section of underserved maternal smokers, and examined factors contributing to the existence of such policies.

Methods: This study is part of an ongoing behavioral counseling trial, Philadelphia FRESH (Family Rules for Establishing Smoke-free Homes), for low-income, minority maternal smokers with children under the age of 4. Mothers whose children were exposed to SHS were recruited from pediatric primary care and WIC clinics. Preliminary baseline data from 189 mothers were analyzed for this study (a larger sample size will be presented.)

Results: Total in home smoking bans were reported by only 11.8% of new mothers; 7.1% permitted smoking only for special guests, 54.7% permitted smoking only in designated areas, and 26.5% permitted smoking anywhere. Mothers reporting greater knowledge about dangers of SHS exposure were more likely to have smoking restrictions (F=2.4, p<0.01). However, smoking bans were not associated with the mother enforcing the policy, and there was no significant association between a smoke-free policy in the home and a smoking ban in the car.

Conclusion: Health advocates and clinicians should educate new mothers on the dangers of SHS as a step towards developing a smoke-free policy in the home. However, helping mothers develop strategies to enforce such policies may be necessary to protect children from exposure.