Household smoking restrictions more strongly associated with better health status than workplace smoking restrictions

In the first study of its kind to evaluate how smoking restrictions in the workplace and at home affect health status, researchers at the Mailman School of Public Health found that nonsmokers who live under both a total household and total workplace smoking ban are over two and a half times more likely to report better health than those without smoking bans.

The study surveyed 1,472 Chinese American adults who live and work in New York City.

The study confirms that household smoking restrictions are more strongly associated with better health status than workplace smoking restrictions. "As the policy environment continues to move toward comprehensive protection at the workplace, the household increasingly will become the main and perhaps the only significant source of exposure among nonsmoking adults as it is among children," observes Donna Shelley, MD, Mailman School assistant professor of clinical Sociomedical Sciences, director of the Tobacco Cessation Program, and co- investigator of the research with principal investigator Marianne Fahs, PhD, Hunter College.

Smoking restrictions have a dual goal, to protect the health of nonsmokers and to increase smoking cessation among smokers. Since smoke-free public places appear to facilitate the adoption of smoke-free homes, and as smoke-free air legislation spreads, a rise in protection from secondhand smoke at home can be expected. "However, this does not, preclude the need to take a proactive approach to increasing adoption of household bans," says Dr. Shelley.

The study suggests that while household smoking bans cannot be legislated, governmental agencies can increase their efforts in developing and testing effective interventions to promote household smoking policies. "By highlighting potential health benefits of promoting workplace legislation and voluntary household smoking restrictions, this research provides additional rationale for more aggressively promoting voluntary household smoking bans," notes Dr. Shelley.

The data also confirm that among Asian Americans the most at risk are the least acculturated non-English speaking immigrants. Before the New York City Clean Indoor Air Act of 2003, second-hand smoke exposure among this immigrant Chinese population at home and work was high, note the researchers. "Particular attention must be paid to influencing smokers who are most likely to benefit from these policies but who are less likely to have smoke-free homes and whose families are most at risk," says Dr. Shelley.