'They only smoke in the house when I'm not in': understanding the limited effectiveness of a smoke-free homes intervention.


Journal

Journal of public health (Oxford, England)
ISSN: 1741-3850
Titre abrégé: J Public Health (Oxf)
Pays: England
ID NLM: 101188638

Informations de publication

Date de publication:
22 09 2021
Historique:
received: 21 01 2020
revised: 14 11 2019
accepted: 14 01 2020
pubmed: 24 4 2020
medline: 25 2 2023
entrez: 24 4 2020
Statut: ppublish

Résumé

Children's second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. Personalized household air-quality measurements can promote changes in smoking that reduce SHS exposure. The 'First Steps 2 Smoke-free' (FS2SF) intervention is the first to trial this approach delivered as part of health professionals' routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied. 120 women were recruited from the NHS First Steps Programme, which supports disadvantaged mothers. They received either personalized feedback on their home air quality and advice on reducing SHS or standard SHS advice. Qualitative interviews with 15 mothers were analyzed thematically using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. The intervention increased women's capability to change home-smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others' smoking in the home. The FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage.

Sections du résumé

BACKGROUND
Children's second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. Personalized household air-quality measurements can promote changes in smoking that reduce SHS exposure. The 'First Steps 2 Smoke-free' (FS2SF) intervention is the first to trial this approach delivered as part of health professionals' routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied.
METHODS
120 women were recruited from the NHS First Steps Programme, which supports disadvantaged mothers. They received either personalized feedback on their home air quality and advice on reducing SHS or standard SHS advice. Qualitative interviews with 15 mothers were analyzed thematically using the Capability, Opportunity, Motivation, Behaviour (COM-B) model.
RESULTS
The intervention increased women's capability to change home-smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others' smoking in the home.
CONCLUSIONS
The FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage.

Identifiants

pubmed: 32323719
pii: 5823909
doi: 10.1093/pubmed/fdaa042
pmc: PMC8458016
doi:

Substances chimiques

Tobacco Smoke Pollution 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

647-654

Subventions

Organisme : Chief Scientist Office
ID : CZH/4/983
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M026159/1
Pays : United Kingdom
Organisme : Scottish Government Chief Scientist Office
ID : CZH_4_983

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of Faculty of Public Health.

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Auteurs

R O'Donnell (R)

Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK.

A Amos (A)

Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK.

S W Turner (SW)

Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK.

L Adams (L)

NHS Lanarkshire, Airdrie ML6 6DB, UK.

T Henderson (T)

NHS Lanarkshire, Hamilton ML3 0TA, UK.

S Lyttle (S)

NHS Lanarkshire, Hamilton ML3 0TA, UK.

S Mitchell (S)

NHS Lanarkshire, Hamilton ML3 0TA, UK.

S Semple (S)

Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK.

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Classifications MeSH