PARENTS WHO SMOKE: TOBACCO ATTITUDES AND PRACTICES THAT AFFECT CHILDREN Jonathan P Winickoff ^1,2, Robert C McMillen ³ and Michael Weitzman ⁴. ¹MGH Center for Child and Adolescent Health Policy, Harvard Pediatric Health Services Research Program, Boston, MA; ²MGH Tobacco Research and Treatment Center, Boston, MA; ³Social Science Research Center, Mississippi State University, MS; and ⁴AAP Center for Child Health Research and Strong Children's Research Center, U of Rochester, Rochester, NY.

BACKGROUND: Adverse health consequences of child environmental tobacco smoke (ETS) exposure have been well documented, yet 42% of US children live in households with smokers, and most are exposed in multiple public settings.

OBJECTIVE: To compare tobacco attitudes and practices toward restriction of child ETS exposure by smoking and non-smoking parents.

DESIGN/METHODS: Data come from a random household telephone survey of adults conducted in the summer of 2001 using a national probability sample. The analysis compared attitudes and practices regarding child ETS exposure of smoking and non-smoking parents.

RESULTS: Of 3,566 eligible respondents contacted, 3,002 (84%) completed surveys and 900 (30%) were parents who had children living at home. Of these parents, 180 (20%) were current smokers. Overall, most U.S. households ban smoking when children are present (88%) and most adults recognize the dangers of ETS (95%). Smoking prohibition inside the home was more prevalent among non-smoking parents than smoking parents (89% vs 39%). More non-smoking parents than smoking parents reported that it is not acceptable for parents to smoke in front of children (88% vs 52%), and more supported smoke free shopping malls (81% vs 64%), convenience stores (90% vs 83%), and fast food restaurants (86% vs 63%). Support for youth tobacco prohibition in schools was greater among non-smoking parents than smoking parents (93% vs 84%), as was support for penalties for the sale of tobacco to minors (93% vs 84%) and youth possession (85% vs 71%). P<.05 for all comparisons.

CONCLUSIONS: These nationally representative data demonstrate that a substantial percentage of US children continue to be exposed to preventable sources of ETS. Although significant differences in tobacco control attitudes and practices exist between non-smoking parents and smoking parents, a broad majority favor greater prohibition of child ETS exposure. This parental consensus, that includes even smoking parents, should help guide public policy regarding child exposure to tobacco smoke.