Research shows that household smoking restrictions are associated with less exposure to secondhand smoke in adolescents and children. Chronic exposure to secondhand smoke in children, most of which occurs in the home, is related to increased lower respiratory infections, ear disorders and severity of asthma symptoms. In adults, substantial evidence links secondhand smoke to lung cancer in nonsmokers. Further, household smoking restrictions are an integral component of anti-smoking socialization and may aid in preventing smoking onset in youth. Restricting smoking in the home may also aid smokers in their efforts to quit. Despite the potential of household smoking restrictions to contribute to decreased prevalence of smoking, very little research has been done on the process families go through in adopting and maintaining a smoke-free home. The purpose of the proposed research is to gain an in-depth understanding of the smoke-free home adoption and maintenance process, including the facilitating and inhibiting factors at several levels of influence (individual, interpersonal and community). We propose to conduct semi-structured interviews with 120 African American and white adults in 60 households of adolescents ages 10-14. Participants will be recruited from three rural counties in southwestern Georgia. Participants will be from low-income households where no adults smoke, where at least one adult smokes and one adult does not smoke, and households where all of the adults smoke. Primary caregivers of the adolescent will be interviewed in 30 of the households and all adults will be interviewed in the other 30 households. Analysis methods include content analysis and pattern matching to identify similarities and differences across household and family types, race/ethnicity, and smoking status of the household members. Findings from this formative research will provide the foundation upon which to design and test effective strategies for creating smoke-free homes in rural, low-income communities.
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