The effect of smoke-free homes on smoking behavior in the U.S.

BACKGROUND: Evidence from longitudinal population surveys is needed to establish whether smoke-free homes might influence smoking behavior.
METHODS: The Tobacco Use Supplement of the nationally representative U.S. Current Population Survey (TUS-CPS) interviewed 3292 adult recent smokers in 2002 and again 12 months later. Both surveys measured smoking status, rules on smoking in the home, and the number of cigarettes smoked per day (cpd). For the main study outcome, an early marker of successful cessation (>or=90 days quit) was used. Analysis was completed in 2008.
RESULTS: In the 12 months ending February 2003, the prevalence of smoke-free homes among recent smokers increased from 33% to 39%. A smoke-free home at baseline was associated with >or=90 days cessation at follow-up (10.9% vs 6.2%, AOR=1.44; 95% CI=0.97, 2.21), and those who maintained a smoke-free home were more likely to be >or=90 days quit than those who did not (12.9% vs 5.7%, AOR=1.99; 95% CI=0.93, 4.25). However, adopting a smoke-free home during the year was associated with a nearly fivefold increase in the percentage of >or=90 days quit (AOR=4.81; 95% CI=3.06, 7.59). This increase was seen among all smokers, including moderate-to-heavy smokers (>or=90 days quit: a smoke-free home=13.0% vs no smoke-free home=2.9%, p<0.001). Among continuing smokers with a smoke-free home at baseline, maintenance of te smoke-free home was associated with a decline in consumption (micro=or-2.18; 95 CI=or-1.24; -3.10 cpd). Among continuing smokers with no smoke-free home at baseline, adoption of that status was also associated with a decline in consumption (micro=or-1.72; 95% CI=or-0.58; -2.85 cpd).
CONCLUSIONS: This study provides strong evidence that the adoption of a smoke-free home is associated with successful quitting among smokers in the U.S.