EVIDENCE BASED PUBLIC HEALTH POLICY AND PRACTICE

Population level policy options for increasing the prevalence of smokefree homes

George Thomson, Nick Wilson, Philippa Howden-Chapman

Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand

Correspondence to:
Correspondence to:
DrG Thomson
Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, New Zealand; gthomson{at}wnmeds.ac.nz

Objective: To identify and evaluate the options for population level government policies to increase the prevalence of homes free of secondhand smoke.

Methods: The literature was searched for population level policy options and evidence on them. Three criteria were used to evaluate the policy options: effectiveness, the reductions on inequalities in secondhand smoke exposure, and cost effectiveness. The setting was four developed, English speaking jurisdictions: Britain, USA, Australia, and New Zealand.

Results: Evidence from all four countries shows some association between relatively comprehensive tobacco control programmes and lower prevalence levels of smoking in homes. The evidence of the effect of such programmes on inequalities in smokefree home prevalence is limited. No published evidence was found of the cost effectiveness of the programmes in achieving changes in smokefree homes. Within comprehensive programmes, there is some indirect evidence that some mass media campaigns could increase the prevalence of smokefree homes. Structural options that have potential to support smokefree homes include smokefree places legislation, and laws for the protection of children.

Conclusion: The available evidence to date suggests that comprehensive tobacco control programmes (to reduce the prevalence of smoking in the total population) are likely to be the most effective and sustainable option for increasing the prevalence of smokefree homes.

Keywords: tobacco smoke pollution; homes

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