Secondhand smoke education

Secondhand smoke education informs smokers and non-smokers of the dangers of secondhand smoke. These efforts encourage smokers to smoke less in their homes and non-smokers to implement home smoking bans. Education can be delivered through counseling, health care programs, home visiting, informational materials, or media messages. Educational efforts may be implemented alone, combined with biological feedback (e.g., cotinine feedback), or delivered as part of a multi-component intervention.

Expected Beneficial Outcomes (Rated)

  • Reduced exposure to secondhand smoke

Evidence of Effectiveness

There is mixed evidence about the effects of secondhand smoke education on tobacco use and secondhand smoke (SHS) exposure in the home. Educational interventions have been shown to reduce SHS exposure in some circumstances, but often appear to have no effect on exposure. Additional evidence is needed to confirm effects and understand which specific interventions are effective (, Baxter 2011).

Intensive parental counseling and motivational interviewing have been shown to reduce children’s SHS exposure in some circumstances, but often have no effect on SHS exposure (, , Baxter 2011). Home visits from counselors or coaches appear to reduce SHS in homes, though some tobacco smoke pollution remains (Rosen 2015). Selected interventions for families with infants and small children may also increase home smoking bans and family avoidance of SHS (Brown 2015).

Overall, less intensive interventions, such as brief advice or counseling for family and caregivers, do not appear to affect SHS exposure (). However, select interventions, such as an Atlanta-based effort that includes three mailings and a coaching call, appear to increase home smoking bans and SHS exposure among both smokers and non-smokers, and families with and without children ().

A study of asthma education and motivational interviewing for parents of premature infants in a Rochester, NY NICU suggests a combined approach may reduce infants’ exposure more than education alone, but differences were not sustained over the longer term (). Similarly, a study of families receiving a multi-component intervention to reduce SHS exposure among children undergoing treatment at a pediatric oncology hospital indicates that participating families were more likely to adopt a home smoking ban by three months than peer families; by 12 months both groups were equally likely to have a ban in place ().

Impact on Disparities

Likely to increase disparities

Implementation Resources

ALA-Smoke-free housing - American Lung Association (ALA). Smokefree policies in multi-unit housing: Steps for success.

ANR-Smokefree - American for Nonsmokers’ Rights (ANR). Smokefree lists, maps, and data.

US EPA-Smoke-free homes kit - US Environmental Protection Agency (US EPA). Smoke-free Homes Community Action Kit.

Citations - Evidence

* Journal subscription may be required for access.

Baxter 2011 - Baxter S, Blank L, Everson-Hock ES, et al. The effectiveness of interventions to establish smoke-free homes in pregnancy and in the neonatal period: A systematic review. Health Education Research. 2011;26(2):265-82.

Rosen 2015 - Rosen LJ, Myers V, Winickoff JP, Kott J. Effectiveness of interventions to reduce tobacco smoke pollution in homes: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2015;12(12):16043-16059.

Nicholson 2015* - Nicholson JS, McDermott MJ, Huang Q, Zhang H, Tyc VL. Full and home smoking ban adoption after a randomized controlled trial targeting secondhand smoke exposure reduction. Nicotine & Tobacco Research. 2015;17(5):612-616.

Kegler 2015* - Kegler MC, Bundy L, Haardorfer R, et al. A minimal intervention to promote smoke-free homes among 2-1-1 callers: A randomized controlled trial. American Journal of Public Health. 2015;105(3):530-537.

Collins 2015* - Collins BN, Nair US, Hovell MF, et al. Reducing underserved children's exposure to tobacco smoke: A randomized counseling trial with maternal smokers. American Journal of Preventive Medicine. 2015;49(4):534-544.

Cochrane-Baxi 2014* - Baxi R, Sharma M, Roseby R, et al. Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke. Cochrane Database of Systematic Reviews. 2014;(3):CD001746.

Brown 2015 - Brown N, Luckett T, Davidson PM, DiGiacomo M. Interventions to reduce harm from smoking with families in infancy and early childhood: A systematic review. International Journal of Environmental Research and Public Health. 2015;12(3):3091-3119.

Blaakman 2015* - Blaakman SW, Borrelli B, Wiesenthal EN, et al. Secondhand smoke exposure reduction after NICU discharge: Results of a randomized trial. American Pediatrics. 2015;15(6):605-612.

Citations - Implementation Examples

* Journal subscription may be required for access.

ANR-Smokefree - American for Nonsmokers’ Rights (ANR). Smokefree lists, maps, and data.

Giovino 2009 - Giovino GA, Chaloupka FJ, Hartman AM, et al. Cigarette smoking prevalence and policies in the 50 States: An era of change - The Robert Wood Johnson Foundation ImpacTeen tobacco chart book. Buffalo: State University of New York at Buffalo; 2009.

Date Last Updated

Mar 30, 2016