Parental Reports on Home Smoking Bans among Households with Children in the USA, 1995-2007: Trends, Correlates, and Social Disparities

Background: The adoption of complete home smoking bans can protect children from exposure to involuntary smoking. This dissertation aimed to examine three aspects of home smoking bans among households with underage children from 1995 to 2007 in the US: 1) trends in levels of discordance/concordance between parental reports on home smoking bans, and associated individual and household characteristics; 2) national trends in the prevalence of home smoking bans, and associated individual and household characteristics; and 3) educational disparities in home smoking bans and their association with statewide tobacco control policies. Methods: Data from the 1995-96, 1998-99, 2001-02, 2003 and 2006-07 Tobacco Control Supplement to the Current Population Survey (TUS-CPS), supplemented with data on state-level tobacco control policies were used. Prevalence rates were calculated and logistic regressions were estimated to explore unadjusted and adjusted associations. Results: The overall prevalence of discordant parental reports significantly decreased, while the rates of complete home smoking bans increased over the study period in the U.S. However, disparities persisted. Children living in households with single parents, low income, current smoker parents, less educated parents, or without infants were less likely to be protected by a home smoking ban. Households with less than college education were generally more responsive to anti-tobacco policies. Anti-tobacco media campaigns at the state-level were associated with reduced disparities in home smoking bans by education among households with smokers. Conclusions: Parental concordance on the existence of a home smoking ban increased significantly from 1995 to 2007. Households with single parent, low income, one or two current smokers, parents with less than a college education, or without infants are in need of interventions promoting the adoption of complete home smoking bans. More vigorous tobacco control policies at the state level may help promote the adoption of home smoking bans and reduce educational disparities in these protective behaviors.