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US Adult Attitudes and Practices Regarding Smoking Restrictions and Child Exposure to Environmental Tobacco Smoke: Changes in the Social Climate From 2000–2001

Robert C. McMillen, PhD^*,, Jonathan P. Winickoff, MD, MPH^,,||, Jonathan D. Klein, MD, MPH^,¶ and Michael Weitzman, MD^¶

^* Social Science Research Center, Mississippi State University, Starkville, Mississippi
Tobacco Consortium of the American Academy of Pediatrics’ Center for Child Health Research, Rochester, New York
Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Boston, Massachusetts
^|| Massachusetts General Hospital Tobacco Research and Treatment Center, Boston, Massachusetts
^¶ American Academy of Pediatrics Center for Child Health Research and Strong Children’s Research Center, University of Rochester, Rochester, New York

Objective. A substantial proportion of homes and automobiles serve as settings for environmental tobacco smoke (ETS) exposure, and many public settings that children frequent are still not smoke-free. Tobacco control efforts are attempting to increase smoking bans. The objective of this study was to describe the knowledge, attitudes, and practices of smokers and nonsmokers regarding smoking bans and child ETS exposure in multiple public and private settings and to report changes from 2000–2001.

Methods. Cross-sectional data from the annual Social Climate Survey of Tobacco Control were analyzed for changes in knowledge, attitudes, and practices regarding tobacco. These data were collected via automated, random-digit-dialing telephone surveys that were conducted in the summers of 2000 and 2001. The samples were weighted by race and gender to be representative of the US population.

Results. Response rates for eligible adults actually contacted were 1501 (75%) of 1876 in 2000 and 3002 (84%) of 3566 in 2001. The majority of adults, both smokers and nonsmokers, support smoking bans in a wide variety of places. The percentage of all respondents reporting the presence of smoking bans in several public and private places increased from 2000–2001: the household (69%–74%), in the presence of children (84%–88%), convenience stores (68%–74%), fast-food restaurants (52%–58%), and non-fast-food restaurants (25%–28%). Support for smoking bans also increased in shopping malls (71%–75%), fast-food restaurants (77%–80%), and indoor sporting events (78%–80%). There were no significant changes in support for smoking bans in convenience stores, restaurants, or outdoor parks. Adults’ knowledge of the harm caused by tobacco was unchanged, with the vast majority of adults recognizing the dangers of exposure to ETS from parental smoking (95%) and exposure to ETS in cars (77%).

Conclusions. Small improvements in adult attitudes and practices regarding children’s ETS exposure occurred from 2000–2001. However, a significant number of adults in the United States still report ignorance of the harmful effects of child ETS exposure, and there was no improvement in reported knowledge in this 1-year period. In contrast, a growing majority of smokers and nonsmokers favor restrictions on smoking in public settings, suggesting that states and communities have public support for broad public smoking restriction policies. There are significant roles that pediatricians can play in preventing children’s ETS exposure, through both patient and family education and by moving smoking restriction policies forward on their community’s agenda.

Key Words: tobacco smoke pollution/prevention and control • child • adult

Abbreviations: ETS, environmental tobacco smoke • SCS-TC, Social Climate Survey of Tobacco Control

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