MCHbest. NPM 14.2: Smoking in the Household
Strategy. Smoking Policies/Bans/Legislation
Approach. Support policies/legislation to establish smoking bans in homes, cars, and other family spaces.
Overview. Over the last four decades, substantial progress has been made to control exposure to second-hand smoke in public places, workplaces, and homes, through legislation, education, and approaches to building designs and operations. The Pro-Children Act of 1994 prohibited smoking in facilities that routinely provide federally funded services to children. The Department of Housing and Urban Development published a final rule that was fully implemented in July 2018 that prohibits the use of cigarettes, cigars, pipes, and hookahs in public housing authorities. Many states and local governments have followed suit with laws prohibiting smoking in workplaces and public places. More than half of all states have implemented comprehensive smoke-free laws and enacted laws regulating smoking in multi-unit housing and cars. 1
Evidence. Emerging evidence. Initial research showed positive results for strategies to establish smoking bans in private residences and other areas where infants, children, and adolescents spend significant amounts of time. Further research is needed to identify critical components and confirm effects. Although US households are increasingly adopting private rules to limit exposure to second-hand smoke and prevalence rates are falling, there is a lack of clarity regarding interventions that effectively reduce child exposure at home. For a summary of the evidence and strategies for smoking ban legislations and study results, access The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. (Read more about understanding evidence ratings).
Target Audience. State/National..
Outcome. Reduction of secondhand tobacco smoke exposure in the home. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. There are currently 4 ESMs across all states/jurisdictions that align with components of this intervention strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Support policies/legislation to establish smoking bans in homes, cars, and other family spaces,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).
1Tynan MA, Holmes CB, Promoff G, et al. State and local comprehensive smoke-free laws for worksites, restaurants, and bars - United States, 2015. Morbidity and Mortality Weekly Report 2016; 65(24):623-626.