Perceived social and environmental correlates of smoking in the home in households with children

Background: Despite dramatic decreases in overall secondhand smoke (SHS) exposure, almost one-fifth of children in the U.S. still live with someone who smokes in the home. Individual and household factors such as race and poverty are strongly associated with in-home smoking. However, the influence of social and environmental factors has not been examined. Methods: The 2007 National Survey of Children's Health is a random-digit-dialed survey of households with children less than 18 years of age. Analyses were limited to children living in households where anyone smoked tobacco and a mother was present (n=20,328). Multiple logistic regression was used to test whether social and environmental factors (perceptions of neighborhood safety, conditions, and cohesion) were associated with in-home smoking after controlling for individual and household factors (demographics, health status, family stress). STATA 10.1 commands for complex survey design were used. Results: More than one-fourth (27.9%; 95% CI: 26.6-29.3%) of children lived in a home where a household member smoked inside. Social and environmental factors were significantly associated with in-home smoking in hypothesized directions in bivariate analyses. In the final model, poor neighborhood condition was associated with higher odds of in-home smoking (AOR=1.30, 95% CI: 1.11-1.51) while high neighborhood cohesion was associated with lower odds (AOR=0.80, 95% CI: 0.66-0.96). Conclusion: Results provide preliminary evidence that efforts to address disparities in children's SHS exposure in the home should use a broader social ecological framework that includes social and environmental factors. Additional literature and data will be presented to further develop this framework.