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Nicotine & Tobacco Research Advance Access originally published online on July 24, 2009
Nicotine & Tobacco Research 2009 11(10):1131-1141; doi:10.1093/ntr/ntp122
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

The effect of smoke-free homes on adult smoking behavior: A review

Alice L. Mills, Karen Messer, Elizabeth A. Gilpin and John P. Pierce

Alice L. Mills, M.D., M.P.H., Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego
Karen Messer, Ph.D., Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego
Elizabeth A. Gilpin, M.S., Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego
John P. Pierce, Ph.D., Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego

Corresponding Author: John P. Pierce, Ph.D., Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, 3855 Health Sciences Drive, No. 0901, San Diego, CA 92093-0901, USA. Telephone: 858-822-2380; Fax: 858-822-2399; E-mail: jppierce{at}ucsd.edu


  Abstract

Introduction: Smoke-free homes are known to reduce exposure to harmful secondhand smoke. Recent studies suggest that they may also positively affect smoking behavior among smokers themselves.

Methods: We review the literature on the effect of smoke-free homes on adult smoking behavior. The literature search included database (PubMed) and manual searches of related articles and reference lists for English-language studies published from 1 January 1990 to 16 November 2008.

Results: We identified 16 cross-sectional and 7 longitudinal studies of the population-level association of smoke-free homes with adult smoking behavior. Additional studies provided population estimates of trends in and correlates of smoke-free homes. Prevalence of smoke-free homes varies but has been increasing over time in the countries studied and was greater among smokers who were younger, of higher income or educational attainment, smoked fewer cigarettes per day, or lived with a nonsmoking adult or child. Both longitudinal and cross-sectional studies showed that smokers who had or who newly implemented a smoke-free home were significantly more likely to make a quit attempt and to be abstinent, after controlling for confounding factors. In longitudinal studies, those who continued to smoke had a modest, but significant, decrease in cigarette consumption at follow-up.

Discussion: There is strong and consistent population-level evidence that a smoke-free home is associated with increased smoking cessation and decreased cigarette consumption in adult smokers. As they not only reduce exposure to secondhand smoke but also increase cessation rates, promotion of smoke-free homes should be a key element in tobacco control programs.

Received: February 9, 2009; Accepted: May 21, 2009
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