Home Tobacco Use Policies and Exposure to Secondhand Tobacco Smoke: Findings from Waves 1 through 4 of the Population Assessment of Tobacco and Health (PATH) Study
Abstract
:1. Introduction
2. Methods
3. Measures
4. Analysis Plan
5. Results
5.1. Home Tobacco Use Policy Status
5.2. Secondhand Smoke Exposure
6. Discussion
- A total of 70% of adults completely ban the use of all types of tobacco, and 89% ban the use of at least one type of tobacco product inside their homes.
- Differences in policies were observed by tobacco use status and were consistent with previous research [21].
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Liu, B.; Dompreh, I.; Hartman, A.M. Small-Area Estimation of Smoke-Free Workplace Policies and Home Rules in US Counties. Nicotine Tob. Res. 2021, 23, 1300–1307. [Google Scholar] [CrossRef] [PubMed]
- Daube, M.; White, S.L. Smoke-Free Policies: No Time to Waste. Circulation 2018, 138, 567–569. [Google Scholar] [CrossRef]
- US Public Health Service; Office of the Surgeon General. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General; US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health: Atlanta, GA, USA, 2006; Volume 7092006.
- Americans for Nonsmokers’ Rights. Secondhand Smoke is Still Damagaing Your Health. Available online: https://nonsmokersrights.org/ (accessed on 29 June 2021).
- Tsai, J.; Homa, D.M.; Gentzke, A.S.; Mahoney, M.; Sharapova, S.R.; Sosnoff, C.S.; Caron, K.T.; Wang, L.; Melstrom, P.C.; Trivers, K.F. Exposure to Secondhand Smoke Among Nonsmokers—United States, 1988–2014. MMWR Morb. Mortal. Wkly. Rep. 2018, 67, 1342–1346. [Google Scholar] [CrossRef] [Green Version]
- E-Cigarette Use among Youth and Young Adults: A Report of the Surgeon General; US Department of Health and Human Services, Centers for Disease Control and Prevention: Atlanta, GA, USA, 2016.
- Cheng, Y.-C.; Rostron, B.L.; Day, H.R.; Stanton, C.A.; Hull, L.C.; Persoskie, A.; Travers, M.J.; Taylor, K.; Conway, K.; Ambrose, B.K.; et al. Patterns of Use of Smokeless Tobacco in US Adults, 2013–2014. Am. J. Public Health 2017, 107, 1508–1514. [Google Scholar] [CrossRef] [PubMed]
- Popova, L.; Ling, P.M. Alternative tobacco product use and smoking cessation: A national study. Am. J. Public Health 2013, 103, 923–930. [Google Scholar] [CrossRef]
- Goldade, K.; Choi, K.; Bernat, D.H.; Klein, E.G.; Okuyemi, K.S.; Forster, J. Multilevel predictors of smoking initiation among adolescents: Findings from the Minnesota Adolescent Community Cohort (MACC) study. Prev. Med. 2012, 54, 242–246. [Google Scholar] [CrossRef] [Green Version]
- Hyland, A.; Higbee, C.; Travers, M.J.; Van Deusen, A.; Bansal-Travers, M.; King, B.; Cummings, K.M. Smoke-free homes and smoking cessation and relapse in a longitudinal population of adults. Nicotine Tob. Res. 2009, 11, 614–618. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kruger, J.; Patel, R.; Kegler, M.; Babb, S.D.; King, B.A. Perceptions of harm from secondhand smoke exposure among U.S. adults, 2009–2010. Tob. Induc. Dis. 2016, 14, 3. [Google Scholar] [CrossRef] [Green Version]
- Lidón-Moyano, C.; Martínez-Sánchez, J.M.; Fu, M.; Ballbè, M.; Sanchez, J.C.M.; Martinez, C.; Fernández, E. Secondhand smoke risk perception and smoke-free rules in homes: A cross-sectional study in Barcelona (Spain). BMJ Open 2017, 7, e014207. [Google Scholar] [CrossRef] [PubMed]
- Thomson, G.; Wilson, N.; Howden-Chapman, P. Population level policy options for increasing the prevalence of smokefree homes. J. Epidemiol. Community Health 2006, 60, 298–304. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cheng, K.-W.; Glantz, S.A.; Lightwood, J.M. Association between smokefree laws and voluntary smokefree-home rules. Am. J. Prev. Med. 2011, 41, 566–572. [Google Scholar] [CrossRef] [Green Version]
- Gentzke, A.S.; Homa, D.M.; Kenemer, J.B.; Gomez, Y.; King, B.A. Rules to prohibit the use of electronic vapor products inside homes and personal vehicles among adults in the U.S., 2017. Prev. Med. 2018, 114, 47–53. [Google Scholar] [CrossRef]
- Li, D.; Shi, H.; Xie, Z.; Rahman, I.; McIntosh, S.; Bansal-Travers, M.; Winickoff, J.P.; Drehmer, J.; Ossip, D.J. Home smoking and vaping policies among US adults: Results from the Population Assessment of Tobacco and Health (PATH) study, wave 3. Prev. Med. 2020, 139, 106215. [Google Scholar] [CrossRef]
- Drehmer, J.; Nabi-Burza, E.; Walters, B.H.; Ossip, D.J.; Levy, D.; Rigotti, N.A.; Klein, J.D.; Winickoff, J.P. Parental Smoking and E-cigarette Use in Homes and Cars. Pediatrics 2019, 143, e20183249. [Google Scholar] [CrossRef] [Green Version]
- Zhang, X. The association between indoor smoke-free home rules and the use of cigar and smokeless tobacco: A longitudinal study. Addict. Behav. 2017, 74, 153–155. [Google Scholar] [CrossRef] [PubMed]
- Wu, T.-S.; Chaffee, B.W. Parental Awareness of Youth Tobacco Use and the Role of Household Tobacco Rules in Use Prevention. Pediatrics 2020, 146, e20194034. [Google Scholar] [CrossRef]
- Hyland, A.; Ambrose, B.K.; Conway, K.P.; Borek, N.; Lambert, E.; Carusi, C.; Taylor, K.; Crosse, S.; Fong, G.T.; Cummings, K.M.; et al. Design and methods of the Population Assessment of Tobacco and Health (PATH) Study. Tob. Control 2017, 26, 371–378. [Google Scholar] [CrossRef]
- Kruger, J.; Jama, A.; Homa, D.M.; Babb, S.D.; King, B.A. Smoke-free home and vehicle rules by tobacco use status among US adults. Prev. Med. 2015, 78, 9–13. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- King, B.A.; Dube, S.R.; Homa, D.M. Smoke-Free Rules and Secondhand Smoke Exposure in Homes and Vehicles among US Adults, 2009–2010. Prev. Chronic Dis. 2013, 10, E79. [Google Scholar] [CrossRef] [Green Version]
- Homa, D.M.; Neff, L.J.; King, B.A.; Caraballo, R.S.; Bunnell, R.E.; Babb, S.D.; Garrett, B.E.; Sosnoff, C.S.; Wang, L. Vital signs: Disparities in nonsmokers’ exposure to secondhand smoke—United States, 1999–2012. MMWR Morb. Mortal. Wkly. Rep. 2015, 64, 103–108. [Google Scholar] [PubMed]
- Farrelly, M.C.; Nonnemaker, J.M.; Chou, R.; Hyland, A.; Peterson, K.K.; Bauer, U.E. Changes in hospitality workers’ exposure to secondhand smoke following the implementation of New York’s smoke-free law. Tob. Control 2005, 14, 236–241. [Google Scholar] [CrossRef] [Green Version]
- Jensen, J.A.; Schillo, B.A.; Moilanen, M.M.; Lindgren, B.R.; Murphy, S.; Carmella, S.; Hecht, S.; Hatsukami, D.K. Tobacco smoke exposure in nonsmoking hospitality workers before and after a state smoking ban. Cancer Epidemiol. Biomark. Prev. 2010, 19, 1016–1021. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mulcahy, M.; Evans, D.S.; Hammond, S.K.; Repace, J.L.; Byrne, M. Secondhand smoke exposure and risk following the Irish smoking ban: An assessment of salivary cotinine concentrations in hotel workers and air nicotine levels in bars. Tob. Control 2005, 14, 384–388. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Passey, M.E.; Longman, J.M.; Robinson, J.; Wiggers, J.H.; Jones, L.L. Smoke-free homes: What are the barriers, motivators and enablers? A qualitative systematic review and thematic synthesis. BMJ Open 2016, 6, e010260. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tackett, A.P.; Wallace, S.W.; Smith, C.E.; Turner, E.; Fedele, D.A.; Stepanov, I.; Lechner, W.V.; Hale, J.J.; Wagener, T.L. Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users. Tob. Use Insights 2021, 14, 1179173X21998362. [Google Scholar] [CrossRef] [PubMed]
- Dunbar, Z.R.; Giovino, G.; Wei, B.; O’Connor, R.J.; Goniewicz, M.L.; Travers, M.J. Use of Electronic Cigarettes in Smoke-Free Spaces by Smokers: Results from the 2014–2015 Population Assessment on Tobacco and Health Study. Int. J. Environ. Res. Public Health 2020, 17, 978. [Google Scholar] [CrossRef] [PubMed] [Green Version]
All 3 Product Types Banned (n = 16,782) | Combustible-Tobacco Products Banned (Smokeless or ENDS Use Allowed, n = 4557) | Smokeless or ENDS Use Banned (Combustible-Tobacco Allowed, n = 2069) | No Tobacco Product Use Banned (n = 4347) | ||||
---|---|---|---|---|---|---|---|
Overall | % | 69.5 | 14.5 | 5.3 | 10.6 | ||
95% CI | [68.5,70.5] | [13.8,15.3] | [5.0,5.8] | [10.0,11.2] | |||
Tobacco Use Status | No Past 30-Day tobacco use | % | 79.9 | 12.0 | 3.4 | 4.7 | ** |
95% CI | [78.8,80.9] | [11.1,12.9] | [3.0,3.9] | [4.2,5.3] | |||
Past 30-Day use of combustible-tobacco only | % | 47.0 | 13.6 | 12.0 | 27.4 | ||
95% CI | [45.3,48.7] | [12.7,14.6] | [11.1,12.9] | [25.9,28.9] | |||
Past 30-Day use of ENDS or smokeless tobacco only | % | 28.9 | 52.3 | 5.9 | 12.8 | ||
95% CI | [25.8,32.3] | [49.0,55.6] | [4.5,7.7] | [11.2,14.7] | |||
Past 30-Day poly use of combustible, ENDS, and/or smokeless tobacco | % | 33.1 | 29.4 | 8 | 29.5 | ||
95% CI | [30.6,35.6] | [27.3,31.6] | [7.0,9.1] | [27.4,31.8] | |||
Children in the home (W1) | Yes | % | 71.8 | 14.3 | 4.9 | 9.0 | ** |
95% CI | [70.4,73.1] | [13.3,15.3] | [4.4,5.5] | [8.4,9.8] | |||
No | % | 68.1 | 14.9 | 5.5 | 11.6 | ||
95% CI | [66.9,69.4] | [13.9,15.9] | [4.9,6.0] | [10.8,12.4] | |||
Poverty Status (W1) | Below poverty level | % | 64.2 | 10.5 | 8.8 | 16.4 | ** |
95% CI | [62.4,66.0] | [9.7,11.5] | [8.1,9.6] | [15.2,17.8] | |||
At or above poverty level | % | 70.8 | 16.7 | 3.9 | 8.6 | ||
95% CI | [69.6,72.0] | [15.8,17.8] | [3.4,4.3] | [8.0,9.2] | |||
Sex | Male | % | 67.4 | 15.7 | 5.1 | 11.9 | ** |
95% CI | [66.2,68.6] | [14.7,16.7] | [4.6,5.6] | [11.1,12.6] | |||
Female | % | 71.5 | 13.5 | 5.6 | 9.5 | ||
95% CI | [70.2,72.7] | [12.6,14.4] | [5.1,6.1] | [8.8,10.2] | |||
Race | White only | % | 69.1 | 16.3 | 4.4 | 10.2 | ** |
95% CI | [67.9,70.2] | [15.4,17.3] | [4.0,4.8] | [9.6,10.9] | |||
Black only | % | 66.9 | 6.9 | 11.3 | 15.0 | ||
95% CI | [64.7,68.9] | [5.9,8.0] | [10.1,12.7] | [13.5,16.5] | |||
other | % | 76.0 | 10.5 | 5.5 | 8.1 | ||
95% CI | [73.4,78.3] | [8.8,12.4] | [4.3,6.9] | [6.9,9.6] | |||
Ethnicity | Hispanic | % | 82.7 | 6.7 | 4.9 | 5.7 | ** |
95% CI | [81.1,84.2] | [5.7,7.8] | [4.3,5.6] | [5.0,6.5] | |||
Not Hispanic | % | 67.1 | 16 | 5.4 | 11.5 | ||
95% CI | [65.9,68.2] | [15.1,16.9] | [5.0,5.9] | [10.9,12.2] | |||
Age Group | 18–24 | % | 65.4 | 15.3 | 6.6 | 12.6 | ** |
95% CI | [63.8,67.0] | [14.3,16.4] | [5.9,7.4] | [11.7,13.6] | |||
25–44 | % | 67 | 18 | 4.9 | 10.2 | ||
95% CI | [65.5,68.5] | [16.9,19.1] | [4.4,5.4] | [9.4,11.0] | |||
45+ | % | 71.9 | 12.3 | 5.3 | 10.4 | ||
95% CI | [70.6,73.2] | [11.3,13.3] | [4.7,6.0] | [9.7,11.2] |
N | % | Lower | Upper | |
---|---|---|---|---|
Complete ban on all tobacco use at both waves | 11,639 | 58.5 | 57.4 | 59.6 |
Allow some tobacco use at baseline, all tobacco use banned at follow up | 4115 | 11.1 | 10.5 | 11.6 |
Allow some tobacco use at both waves | 7828 | 21.7 | 20.9 | 22.6 |
All tobacco use banned at baseline, allow some tobacco use at follow up | 2489 | 8.7 | 8.2 | 9.2 |
Odds | 95% CI | |||||||
---|---|---|---|---|---|---|---|---|
N | % | 95% CI | Ratio | Lower | Upper | |||
Overall | 4115 | 11.1 | [10.5,11.6] | |||||
Tobacco Use Status | No Past 30-Day tobacco use | 2313 | 10.1 | [9.4,10.9] | 1.00 | Referent | ||
Past 30-Day use of combustible tobacco only | 1145 | 13.3 | [12.5,14.1] | 1.48 | 1.30 | 1.69 | ** | |
Past 30-Day use of ENDS or smokeless tobacco only | 224 | 13.6 | [11.7,15.7] | 1.34 | 1.03 | 1.75 | * | |
Past 30-Day poly use of combustible, ENDS, and/or smokeless tobacco | 433 | 14.6 | [13.0,16.3] | 1.39 | 1.13 | 1.70 | ** | |
Children in the home (W1) | Yes | 1010 | 9.1 | [8.3,9.9] | 1.00 | Referent | ||
No | 1492 | 10.4 | [9.7,11.2] | 1.20 | 1.04 | 1.39 | * | |
Poverty Status (W1) | Below poverty level | 868 | 11.0 | [10.2,11.9] | 1.00 | Referent | ||
At or above poverty level | 1413 | 9.3 | [8.6,10.1] | 0.88 | 0.78 | 1.00 | ||
Sex | Male | 2063 | 11.6 | [10.9,12.3] | 1.00 | Referent | ||
Female | 2052 | 10.6 | [9.8,11.4] | 0.93 | 0.82 | 1.05 | ||
Race | White only | 2881 | 10.7 | [10.1,11.3] | 1.00 | Referent | ||
Black only | 705 | 12.2 | [11.2,13.3] | 1.08 | 0.94 | 1.24 | ||
other | 529 | 12.4 | [10.7,14.3] | 1.12 | 0.89 | 1.40 | ||
Ethnicity | Hispanic | 931 | 10.4 | [9.3,11.6] | 1.00 | Referent | ||
Not Hispanic | 3184 | 11.2 | [10.6,11.8] | 1.24 | 1.03 | 1.49 | * | |
Age Group | 18–24 | 2075 | 21.4 | [20.4,22.5] | 1.4 | 1.2 | 1.7 | ** |
25–44 | 1095 | 10.1 | [9.3,10.9] | 1.1 | 1.0 | 1.3 | ||
45+ | 945 | 9.4 | [8.5,10.3] | 1.0 | Referent |
W1 (2013/14) to W2 (2014/15) | W2 (2014/15) to W3 (2015/16) | W3 (2015/16) to W4 (2016/18) | |||||
---|---|---|---|---|---|---|---|
n = 22,547 | n = 24,021 | n = 25,806 | |||||
Adults | Hours SHS Exposure at follow up | 95% CI | Hours SHS Exposure at follow up | 95% CI | Hours SHS Exposure at follow up | 95% CI | |
Overall | 5.0 | [4.7–5.2] | 4.6 | [4.4–4.9] | 4.2 | [4.0–4.5] | * |
Complete ban on all tobacco use at both waves | 1.8 | [1.7,2.0] | 1.8 | [1.6,2.0] | 1.6 | [1.5,1.8] | |
Allow some tobacco use at baseline, all tobacco use banned at follow up | 4.5 | [4.0,5.0] | 3.9 | [3.4,4.4] | 3.6 | [3.1,4.0] | |
Allow some tobacco use at both waves | 13.3 | [12.4,14.1] | 12.8 | [11.8,13.8] | 11.2 | [10.3,12.1] | * |
All tobacco use banned at baseline, allow some tobacco use at follow up | 6.8 | [5.9,7.8] | 5.0 | [4.4,5.5] | 5.5 | [4.7,6.2] | |
p-value (difference between policy change levels) | <0.001 | <0.001 | <0.001 | ||||
W1 (2013/14) to W2 (2014/15) | W2 (2014/15) to W3 (2015/16) | W3 (2015/16) to W4 (2016/18) | |||||
n = 6880 | 8636 | n = 10,197 | |||||
Youth (Based on parent self-report of home tobacco use bans) | Hours SHS Exposure at follow up | 95% CI | Hours SHS Exposure at follow up | 95% CI | Hours SHS Exposure at follow up | 95% CI | |
Overall | 2.8 | [2.5,3.2] | 2.2 | [1.9,2.5–2.7] | 2.1 | [1.9,2.4] | * |
Complete ban on all tobacco use at both waves | 1.4 | [1.0,1.8] | 1.1 | [0.9,1.3] | 0.9 | [0.7,1.0] | |
Allow some tobacco use at baseline, all tobacco use banned at follow up | 1.9 | [1.4,2.4] | 1.4 | [1.1,1.7] | 1.9 | [1.4,2.4] | |
Allow some tobacco use at both waves | 6.8 | [5.7,7.9] | 5.3 | [4.4,6.1] | 5.3 | [4.6,6.0] | |
All tobacco use banned at baseline, allow some tobacco use at follow up | 2.0 | [1.2,2.8] | 2.6 | [1.8,3.5] | 2.9 | [1.7,4.2] | |
p-value (difference between policy levels) | 0.10 | <0.001 | <0.001 |
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Rivard, C.; Brown, A.; Kasza, K.; Bansal-Travers, M.; Hyland, A. Home Tobacco Use Policies and Exposure to Secondhand Tobacco Smoke: Findings from Waves 1 through 4 of the Population Assessment of Tobacco and Health (PATH) Study. Int. J. Environ. Res. Public Health 2021, 18, 9719. https://doi.org/10.3390/ijerph18189719
Rivard C, Brown A, Kasza K, Bansal-Travers M, Hyland A. Home Tobacco Use Policies and Exposure to Secondhand Tobacco Smoke: Findings from Waves 1 through 4 of the Population Assessment of Tobacco and Health (PATH) Study. International Journal of Environmental Research and Public Health. 2021; 18(18):9719. https://doi.org/10.3390/ijerph18189719
Chicago/Turabian StyleRivard, Cheryl, Anthony Brown, Karin Kasza, Maansi Bansal-Travers, and Andrew Hyland. 2021. "Home Tobacco Use Policies and Exposure to Secondhand Tobacco Smoke: Findings from Waves 1 through 4 of the Population Assessment of Tobacco and Health (PATH) Study" International Journal of Environmental Research and Public Health 18, no. 18: 9719. https://doi.org/10.3390/ijerph18189719