UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
Nicotine Tob Res. 2022 Nov 12;24(12):1985-1993. doi: 10.1093/ntr/ntac186.
Parents/guardians can effectively reduce tobacco smoking and secondhand smoke exposure among youth by adopting and enforcing rules against indoor tobacco smoking (ie, home smoke-free policies). We investigate home smoke-free policies from childhood to adolescence in the United States and across rural, suburban, and urban households.
We analyzed 2019-2020 National Survey of Children's Health data from n = 5,955 parents of youth aged 0-17, living at home with a tobacco smoker in the United States (U.S). Geographical categories were: rural, suburban, and urban. Home smoke-free policy reflected prohibiting tobacco smoking inside the home. Weighted logistic regressions examined the (1) association between youth age and home smoke-free policies, (2) interaction between geographic category and youth age, and (3) differing associations between youth age and home smoke-free policies by geography. Models controlled for youth race, ethnicity, sex, parental education, household annual income, and home structure.
Approximately 13.2% of U.S. households with a smoker did not have a home smoke-free policy. Stratified analyses found one-year increase in youth age was associated with lower odds of having a home smoke-free policy in rural (aOR:0.91; 95%CI: 0.87-0.95) and urban (aOR: 0.96; 95%CI: 0.92-1.00; p = .039), but not suburban (aOR:1.00; 95%CI: 0.95-1.05) households, controlling for covariates.
Odds of having a smoke-free home in the U.S. declined significantly in rural (9% per year) and urban (4%) but not suburban (0%) households. We quantify declines in home smoke-free policies as children age and identify geographic disparities for this environmental determinant of health.
Health promotion efforts targeting secondhand smoke prevention is needed, particularly for parents of older youth. Furthermore, there is a clear geographic bias in secondhand smoke exposure among all youth particularly older youth. Tailored interventions are needed to address geographic disparities in secondhand smoke exposure among rural and urban youth.
父母/监护人可以通过制定和执行禁止室内吸烟（即家庭无烟政策）的规定，有效地减少青少年吸烟和二手烟暴露。我们调查了美国农村、郊区和城市家庭中从儿童期到青春期的家庭无烟政策。
我们分析了来自美国 2019-2020 年全国儿童健康调查的数据，该调查涉及 5955 名家中有吸烟者的 0-17 岁青少年的父母。地理类别为：农村、郊区和城市。家庭无烟政策反映了禁止在家中吸烟。加权逻辑回归检验了以下内容：（1）青少年年龄与家庭无烟政策之间的关系；（2）地理类别与青少年年龄之间的相互作用；（3）不同地理区域中青少年年龄与家庭无烟政策之间的关联差异。模型控制了青少年的种族、民族、性别、父母教育程度、家庭年收入和家庭结构。
约有 13.2%的美国家庭有吸烟者但没有家庭无烟政策。分层分析发现，青少年年龄每增加一岁，农村（调整后的比值比[aOR]：0.91；95%置信区间[CI]：0.87-0.95）和城市（aOR：0.96；95%CI：0.92-1.00；p =.039）家庭拥有无烟家庭政策的可能性降低，但郊区（aOR：1.00；95%CI：0.95-1.05）家庭则不然，控制了协变量。
在美国，农村（每年 9%）和城市（每年 4%）家庭中拥有无烟家庭的可能性显著下降，但郊区（每年 0%）家庭则不然。我们量化了随着儿童年龄增长而无烟家庭政策的下降，并确定了健康的这一环境决定因素在所有年龄段的青少年中存在地理差异。
需要针对二手烟预防开展健康促进工作，特别是针对年龄较大的青少年的父母。此外，所有青少年，特别是年龄较大的青少年，都存在明显的地理上的二手烟暴露差异。需要采取有针对性的干预措施，解决农村和城市青少年之间二手烟暴露的地理差异。
