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Eur J Public Health. 2019 Apr 22. pii: ckz054. doi: 10.1093/eurpub/ckz054. [Epub ahead of print]

Sociodemographic factors associated with secondhand smoke exposure and smoking rules in homes with children.

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Agència de Salut Pública de Barcelona, Servei d'Avaluació i Mètodes d'Intervenció, Barcelona, Spain.
CIBER de Epidemiología y Salud Pública, Madrid, Spain.
Department of Experimental and Health Science, Universitat Pompeu Fabra (UPF), Barcelona,Spain.
Institut d'investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain.
Epidemiology Unit, Galician Directorate for Public Health, Galician Health Authority, Xunta de Galicia, Santiago de Compostela, Spain.
Department of Preventive Medicine and Public Health, School of Medicine, University of Santiago de Compostela, Spain.
Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Spain.
Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.
Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de llobregat, Barcelona, Spain.



This study aims to identify sociodemographic characteristics associated with secondhand smoke (SHS) exposure and the adoption of smoking bans in homes with children in Spain.


We performed, in 2016, a cross-sectional study to a representative sample of Spanish households with children under 12 years old. We administered a telephone survey to the parents asking about smoking patterns at home, children's SHS exposure and sociodemographic characteristics. Poisson regression models with robust variance were built to assess sociodemographic characteristics associated with household SHS exposure and the adoption of smoking rules.


In this study participated 2411 families, 25.8% of which reported exposure at home and 84.4% implemented smoking bans. SHS exposure was associated with having one (aPR = 2.09; 95% CI: 1.43-3.04) or two Spanish parents (aPR = 1.71; 95% CI: 1.24-2.36), lower educational attainment (primary: aPR = 1.74; 95% CI: 1.45-2.10; secondary: aPR = 1.37; 95% CI: 1.17-1.60 compared with university studies), a family structure different from two-parent family (aPR = 1.38; 95% CI: 1.14-1.67) and parents between 31 and 40 years (aPR = 0.75; 95% CI: 0.57-0.99) and 41-50 years (aPR = 0.62; 95% CI: 0.47-0.81) compared with 18- to 30-year-old parents. The adoption of smoking bans was associated with two-parent family (aPR = 1.09; 95% CI: 1.01-1.17), living with non-smokers (aPR = 1.46; 95% CI: 1.31-1.62), parents of foreign origin (aPR = 1.09; 95% CI: 1.04-1.14) and younger children (0-3 years: aPR = 1.05; 95% CI: 1.01-1.09) compared with the oldest children (8-11 years).


The parent's origin and the family structure were associated with SHS exposure and the adoption of smoking bans at home. Moreover, the number of smokers living at home was relevant for the adoption of smoking bans, and the educational attainment for SHS exposure. These factors should be taken into consideration when designing or implementing smoke-free home programmes.


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