The relationship of household smoking environments and cessation history, plans, and self-efficacy among low-income smokers.

Widome RL, Joseph A, Hammett PJ, Burgess DJ, Thomas J, Saul J, Clothier B, Fu SS. The relationship of household smoking environments and cessation history, plans, and self-efficacy among low-income smokers. Paper presented at: Society for Research on Nicotine and Tobacco Annual Conference; 2015 Feb 26; Philadelphia, PA.

Objective: Low-income smokers face numerous barriers to quitting smoking that include hurdles at the individual level (e.g. lack of knowledge about evidence-based tobacco treatment) and environmental factors (e.g. broader community norms, social circle factors that may subtly discourage quitting). Despite these barriers, low-income smokers' household environments could facilitate quitting by making it seem possible, desirable, and thus something to strive for. We sought to examine how home smoking rules and other household members' smoking behaviors related to low-income smokers' past quit attempts, readiness to quit, and self-efficacy to quit. Methods: OPT-IN was a randomized controlled trial of proactive tobacco cessation outreach. The study recruited adult smokers age 18-64 from the administrative databases of the state-subsidized Minnesota Health Care Programs. The present analysis used data from OPT-IN's baseline survey, which was completed by 2,406 participants and conducted in 2011/12. We tested household environmental factors' associations with past-year quit attempts, readiness to quit, and quitting self-efficacy in regression models adjusted for race, education, income, age, gender. Results: Smokers who lived in homes with more restrictive household smoking policies were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting (all p < 0.05). Having more friends and family who smoke was associated with lower readiness to quit (p < 0.05) but was not related to past-year quit attempts or quitting self-efficacy. Having one or more household members who smoke was not related to any of the outcomes examined. Conclusions: This study was cross-sectional and thus it is unknown if household policies preceded individuals' quit attempts, quit readiness, or self-efficacy. However, the relationship between household smoking policies and the cessation-oriented outcomes suggests that pro-quitting adjustments to household environment might possibly be accomplished though household policy change, even in the presence of other household members who are smokers.