Introduction
Most people are aware of the dangers of smoking near children, as the dangers passed to adult increases health problems in children. Children are especially susceptible to effects of tobacco smoke exposure as it increases the risk of sudden infant death syndrome, (SIDS), respiratory infections like pneumonia, increased risks of slower lung development, and risks of middle ear diseases. Some adults fail to realize the dangers they are exposing their children by allowing them to be second hand smokers. According to WHO (2011), second hand smoking refers to the smoke that emanates from the breath of a smoker and from the tip of the burning cigarettes, pipes, and cigar. This smoke contains at least 4,000 chemicals and more than 50 known chemicals that cause cancer. A child is exposed therefore to these chemicals when their parents and close relations smoke around the house. Due to the rising need to protect children from smokers at home, the study seeks to find out whether adoption of home smoking ban is connected to the physical and mental health of smokers and to prevent parents from smoking around children and educate then on the dangers they pose to their children through smoking.
Statement of the Problem
Many parents who are smokers comment that they do not want their children to grow up to be smokers due to the health and social effects of smoking, yet they fail to understand that the breath children take from them at home and in cars is as deadly as smoking itself. Secondhand smoking results to at least 3,000 annual deaths from lung cancer and thousands of deaths from heart diseases to non-smokers. Millions of children are exposed to breathing in second hand smoke in their own homes, which is riskier to their health since their lungs are still developing. According to Mayall (2000), the effects on children is high since the dangerous toxins remain in the places where smokers were, such as on the seat of the car, and even on the hair of a child. Infants are at higher risks of SIDS when exposed to smoking at home. The effects include stuffy nose, headache, sore throat, eye irritation, and hoarseness. It is moreover worrying that such children may grow up becoming smokers themselves and experience more problems later in life. Where at least a parent smokes, children should be totally protected from the effects by a total ban on smoking within the house and in the car.
Several known effects to children exposed to smoking at home include higher rates of acquiring airways infections, such as bronchitis, and pneumonia in the first two years of life. Such children are likely to develop wheeze illnesses and obtain more hospital admissions, which negatively translate to poor academics and general development. These children are more likely to acquire otitis media, which can result to hearing loss and delay of speech development. There is lower lung function experienced in such children implying that these children cannot breathe deeply as other children. Such children are affected with reduced lung function that may prevail even in adulthood. Among the school-going children who are secondhand smokers, symptoms such as cough, phlegm, wheeze, and breathlessness are more common. In addition to this, they are more prone to asthmatic attacks that may compel them to use asthma medications for longer periods. Increased risk of infection is caused by impaired immune system in both children and adults who are second smokers. Other related complications include the risks of meningococcal disease, which may lead to death, mental disability, and loss of limbs. Since children of parents who smoke have higher rates of being affected health wise as compared to children of non-smokers, it is necessary that health professionals arise to the need to raise awareness on the need to ban smoking at home and in cars for the sake of better wellness of the children (Glover, 2013).
Literature Review
It has been confirmed that homes and cars remain primary areas of SHS exposure for children (Patterson, 2015) Minimizing children’s exposure to SHS in the home is significant in public health as exposures is connected to exacerbation of illnesses like asthma and middle ear infection, that further affects school attendance and success and increases hospital admissions. These challenges are connected to the parents’ poor knowledge on the association between exposure to SHS and health risks among children.
According to Ritchie, Amos, Phillips, Cunningham-Burley, & Martin (2009), smoking is a major cause of inequalities in the health sector in Scotland. This is according to the data given in 2003, which classified 41% of men and 39% of women in semi-routine and routine occupations smoking cigarettes. This estimation is compared to 17% of men and 16% of women who occupy managerial positions. From the study, it is apparent that smoking is more prevalent among the low-income communities. However, before the introduction of smoke free legislations, in Scotland, bars, among other work places were less likely to be guided by a policy and were more likely to allow smoking than in affluent communities.
According to Rouch et al (2010), the policy makers are charged with the role of ensuring that governments intervene in the health of the smokers. The policies have been set to protect children from associated risks of smoking parents. The policies undertaken include conducting investigations on risks on children, from laws on reproduction, abortion, suicide, environmental health protection, fluoridation of water supplies, and compulsory food additives. The government bears the authority if finding out adult behavior in private vehicles where the behavior of the users may threaten the welfare of children. When writing these policies, it becomes unclear what constitutes public and private entities. This lack of distinction between public and private comprises of the level to which spaces and activities are closed to the public, and limits government authorities on exercising their mandate in investigating personal behavior. This has resulted to false accusations on negligence of roles by some societies who perceive that the government ought to exercise its mandate on preventing children violence in some spaces (Asbridge & Cartwright, 2010). The ill-defined boundary between public and private furthermore limits the central governments and local authorities on the extent they should take to protect children from smoking.
Introduction of smoke free legislations has resulted to increased home smoking restrictions and hence successful in minimizing children’s exposure to second-hand smoke. It is confirmed that smoke-free homes and people with adverse knowledge on the hazards of smoking may adopt smoke-free cars and public places (Thomsom, Hudson, & Edwards, 2010). Among the basic intervention, programs by the government include reduction of the prevalence of smoking and precise policies on population level as additional strategy for governments to employ to curb smoking among children. These policies incorporate smoke-free schools, outdoor areas, cars, and media campaigns to modify the behaviors of smokers around children (Thomsom, Hudson, & Edwards, 2010).
Health professionals have an upper hand at encouraging smoke-free homes for children. However, there are little conclusive proofs that the professionals’ interventions are effective (Bell, McNaughton & Salmon, 2009). A Cochrane review of 18 RCT’s that sought to minimize parent’s smoking prevalence realized inadequate proofs to suggest one intervention strategy over the others (Ritchie, Amos, Phillips, Cunningham-Burley, & Martin, 2009). Another study by the US nurses confirmed that by using self-help materials and counseling, parents can reduce some exposure but is not useful in increasing cessation. Some studies experienced success in applying counseling and feedback of the pulmonary functions for parents of asthmatic children. Other studies prove that outpatient pediatric clinics were successful in encouraging adults to quit smoke-free homes are extremely low.
Even though numerous researches have been conducted on the effects of smoking in the home and cars to children, little research has been conducted to capture the reactions and feelings of the affected children. From the studies by Rowa-Dewar, Amos and Cunningham-Burley (2013), most of the children, irrespective of their social and economic status strongly dislike such acts. The study reveals reactions such as overt and covert acts of resistance, which involves challenging relatives about their smoking behavior. The participants expressed disgust and concern of smoking in the home and even go to the extent to hiding cigarettes as a way of separating themselves from the smokers. These acts are at times conducted with support from the non-smoking relatives. This study shows that even children distaste smoking in the home and in cars, they are aware of some effect (Glover, 2013). This resistance appears to increase with age and social norms irrespective of the fact that the young person may not be a smoker. Besides profound studies conducted on the topic, it is still unclear the degree of safe exposure to tobacco smoke pollution to children (Coxhead & Rhodes, 2006). Conversely, exposure of children to smoke pollution bears short term and long-term effects on health (Donnelly & Whittle, 2008). Associated risks to children include children experimenting with tobacco and becoming addicted after seeing adults enjoying tobacco (Glover, Kira, & Faletau, 2013).
Summary
Children are very vulnerable to health risks and especially chemicals derived from smoking. This is because their bodies are not yet fully developed to counter associated reactions. Exposure of children to second hand smoke causes approximately 30,000 deaths annually in US (U.S. Department of Health and Human Services, 2014). As nonsmokers, such children are exposed to smoke that increases their risk of developing heart disease by 27%. It has been discovered even older children who are exposed to smoke at home become sick more often as their lungs grow less than for the children who are not exposed to smoke. Wheezing, coughing, ear infections, and asthmatic attacks are some of the harms that affect children exposed to smoking in their homes and in cars. To protect these children, parents should not allow anyone to breathe anywhere near the home, smoke in the car even when the windows are down. Parents should in addition make sure that the dare centers and schools where their children go to are tobacco-free. In case, they are to visit restaurants, they should ensure that those public places do not allow smoking.
Methodology
The study is to apply mixed approach to incorporate the benefits of qualitative and quantitative approaches to evaluate whether adoption of home smoking bans is connected to the physical and mental health of smokers. Qualitative data is useful, as it will capture information that cannot otherwise be quantified and hence more useful for this social research. Other than the findings in numbers, qualitative approach captures associated feelings and experiences, which would otherwise be difficult to be stated in numbers. Quantitative approach is useful in capturing information and analyzing it using statistical approaches to derive precise conclusions. Besides this, qualitative approach will be useful for the focus group, while quantitative for questions.
Subjects
Participants will be recruited from graduate classes at Saint Joseph’s University. Both females and males are expected to participate and give their experience on the topic. The main criteria are to have family members who smoke around their children. Thus, 20 subjects will be selectively picked from the class and all these 20 subjects will be participants. The contributors are to be chosen from diverse backgrounds and races and hence offer more information concerning smoke addiction in different races.
Instrumentation
Participants will be given questionnaires having questions regarding smoking around children and their thoughts about caring about such behaviors. Only participants who have fulfilled the minimum condition of coming from a background with people smoking at home and in cars in the presence of the children will be allowed to take part in the research. Participants are free to avoid answering questions and even leave at will without completing answering the questionnaire. This is to avoid compelling participants to take part unwillingly. Independent variable in this case is personal experience as a victim while the dependent variables are the effects of the smoking bans and the age of the victim.
Procedures
Before participating, contributors are to be notified of the purpose of the study as a contribution on the topic for education and training and not for any personal benefits. For this case, no fees are to be levied on them. The contributors signed consent form indicating that they were willing to participate and that in case they are uncomfortable, they can discontinue without any loss of benefits or penalty. In the consent form, participants were instructed to hide any personal information such as their names and residences that may be used for identification. Participation is voluntary and participants who were unwilling to engage in the study are free to stop their participation at any time without penalty. Contributors are instructed not to include their names, as their identities are to remain confidential and protected. All data collected were coded and hence hid all the personal details of the contributors. After completing the questionnaire, participants are to place the forms in a slot in a closed box to avoid identification of the responses to a given participant.
Research Questions in the questionnaire
- What is smoking?
- Have you had a personal experience with the smokers?
If yes, kindly share
- According to you, which category of people are mostly smokers?
- Why do you think the mentioned category are mostly affected?
- Where do people prefer to smoke?
- In designated public places
- In public
- At home
- Have you heard an experience of people who smoke at home?
- Yes
- No
- Rarely
- b) If Yes, is it possible you define such as experience?
- Why do you think people prefer to smoke at home?
- Do you think the smoke affects children?
- If yes, how
- Do you think smokers affect children?
- if yes, how?
- Have you ever had any reactions from the affected children?
- If yes, kindly explain
- Is there any known difference in terms of impact on children, when smokers prefer to smoke at home rather than in specific identified public places?
- How do you think these impacts can be managed?
- Should the government become involved in managing the effects of smoking at home or is it totally a personal affair?
- Are there laws and policies against smoking at home?
If yes, why are smokers breaking these rules?
- How can the public react in managing the problem of smoking around children at home?
- According to you, is it possible for smokers to avoid totally the problem of smoking at home?
Results
ANOVA as a descriptive statistical technique was used to analyze the data. The Independent variable in this case was personal experience as a victim while the dependent variables are the effects of the smoking bans and the age of the victim. Participants in the study were selected from families where at least a family member smokes around children. Using ANOVA technique in correlating personal experience with the effects of the smoking bans, at least 80% of the participants confirmed that smoking bans are related positively to the mental health of the smokers and not physical health. This was a finding derived from the questionnaire interview used on the 20 participants.
Using ANOVA technique in correlating personal experience with the age of the victims, the study confirmed that at least 70% adults alike are dissatisfied with the ill behavior of smoking at home and in cars. Interviews through the questionnaire makes it clear that the affected call for the government and the health professionals to protect children against the effects of smoking at home and in cars. From the research on secondary data, policies that have been modified to ban smoking in specific places proves that if health professionals can educate the public on the need to set policies distinguishing private and public places, then the health of children can be enhanced (U.S. Department of Health and Human Services, 2014). The findings of this study were found therefore to be similar to the findings derived from reviewed secondary sources. The findings indicate that concluding workers in smoke-free homes initiatives confirms expert knowledge on the on reducing SHS exposure (Thomsom, Hudson & Edwards, 2010). In addition, research findings are to suggest that physical health benefits are widespread and comprise of robust reductions in ETS-related morbidity, mortality, and improvements in indoor air quality, smoking rates, and reductions in uptake of smoking within the youth.
Discussion
Homes and cars remain primary regions where children acquire SHS related complications. Though the public is aware of the dangers of exposing children to smoke, some portions are unaware of these effects at home and in cars. Most of the parents therefore do not desire that their children become smokers yet they smoke in their presence at home in cars where limited policies that ban smoking prevail. This calls for the need of the health practitioners to raise awareness of the associated dangers to children of smoking at home and in the cars. This form of educations is necessary especially when the parents have limited knowledge on the association between exposure to SHS and health risks among children. Raising awareness and educating the public is besides useful in reducing the rate at which children are affected with smoke related illnesses.
From the study, it is necessary for exploration to be conducted to find out the extent to which the presence of home smoking ban affects the health of the smokers, and whether it is associated with good physical and mental health. Only policies that require establishments of being totally smoke-free can protect non-smokers from being exposed to SHS. This assertion is supported by evidence of places that have become smoke free.
From the study, it is apparent that smoking is more prevalent among the low-income communities. Smokers in low-income communities often smoke as a form of leisure and due to limited awareness on the dangers, they are exposing their children to. Other than educating the masses on the need to change their lifestyle, government should come in and assist the low-income communities, improve their economic and social status. Policy makers should ensure that the governments intervene in the health of the smokers to protect children from associated risks of smoking parents. In addition to this, the government should bear the authority finding out adult behavior in private vehicles where the behavior of the users may threaten the welfare of children.
Implications and Conclusion
The study defines challenges that children living in low-income homes experience. The study draws these conclusions after conducting a qualitative Scottish study to identify major issues and challenges that needed to be considered when determining the necessary actions for promoting smoke-free homes. Among the themes that arose during the study, include improvement of knowledge on SHS among carers and professionals and the complexity of the interventions. This study further accentuated the need to define ‘privacy’ in the national and international policies since the term bears sensitivity in conducting health interventions.
This study is useful to public health policy with respect to issues surrounding smoking. This study is further useful as it prevents parents from smoking around children and educates them on the dangers of smoking around children. Data obtained from the study are useful in enlightening present investigators in understanding the effects between smokings around children in their privacy. This understanding will be additionally useful for future investigations on related topics and publications for teaching purposes. Future studies need to consider the level of training health professionals and main stakeholders in issues related to smoking at home and how to address these issues. More research ought to be undertaken to evaluate interventions and generate more robust evidence base for informing effective action on smoking at home.
Minimal questions remain unanswered after the study confirmed that adoption of home smoking bans are positively related to the mental health of the smokers and not physical health. First, there is need to define boundary between private and public. This absence has limited exercise of the present public health polices from being implemented in some regions.
Limitations
Minimal risks and discomforts were experienced among participants due to their experience in answering questions about smoking around their children. Since the study selected participants from the institution, aspects of biasness were eminent since the institution was to be chosen as a sample that would otherwise not depict the reality. Otherwise, minimum problems were experienced when conducting the research. Due to the high number of participants who turned out for the study, it was cumbersome to prove validity of the study. Since the study was focused on individual background, some participants shied away from providing their insight on the topic.
Suggestions for Future Research
Considerable studies have been conducted on the effects of second hand smoking among children. Most of these studies were based on the experiences of the health practitioners and among adult. However, minimal research has been conducted on the experiences and emotional state of the effected children. Future studies need to concentrate on the children and their reactions of seeing family members smoke in their homes and in cars. There is need for the government to conduct studies that define the expectation of the public in managing smoking at home and in cars especially in the presence of children, such studies will heighten the need to define the terms ‘private’ and ‘public’.
Bibliography
Rouch, G., et al. (2010). Public, private and personal: Qualitative research on policymakers’
Opinions on smoke free interventions to protect children in ‘private’ spaces. BMC Public
Health. 10:797
Rouch et al highlights on the government policies and laws that are crucial in protecting the health and social being of the public. This study is useful as it highlights obstacles to, opportunities for government smoke-free regulation of private and public spaces in the protection of children.
Ritchie, D., Amos, A., Phillips, R., Cunningham-Burley, S. & Martin, C. (2009). Action to
Achieve smoke-free homes- an exploration of experts. BMC Public Health 2009, 9:112
The authors highlight smoking at home as a primary cause of exposure to second hand smoke in children in UK. This is especially common among those who live in low-income households and have fewer restrictions on smoking in the home. The authors go on to affirm that reducing exposure to send-hand smoking is significant to public health and issues on inequalities.
Rowa-Dewar, N., Amos, A. & Cunningham-Burley, S. (2013). Children’s resistance to parents’ smoking in the home and car: a qualitative study. UK Centre for Tobacco and Alcohol Studies, Centre for Population Health Sciences, University of Edinburgh.
Rowa-Dewar, Amos and Cunningham-Burley affirms that one primary goal of controlling tobacco is to reduce second-hand smoke exposure in the home. Personal and friendship interviews were conducted between two communities in Edinburgh, Scotland; the socio-economic advantage and socio-economically disadvantaged. The findings depict strong dislike of the members of the family who are smoking. The participants are also concerned of the effect of the behavior on the health of the smoker. It is apparent from a study that indeed some children regardless of their socio-economic status actively oppose parents’ smoking in the home and car. Even though their influence is greatly limited by the position they assume in the family and in the social norms, they strongly dislike the behavior
Asbridge, M. & Cartwright, J. (2010). The Relationship of Home Smoking Bans to the Physical and Mental Health of Smokers. Original Investigation. 1-9
Asbridge & Cartwright, examines whether adoption of home smoking bans is related with the physical and mental health of smokers. This examination was carried out using two potential pathways that relate home smoking bans to smoker’s heath. The first pathway affirms that home smoking bans are positively related to physical health by encouraging smoking cessation while reducing daily cigarette consumption. The second pathway suggests that home smoking bans are negatively correlated to the mental health of the smokers by increasing marginalization and social isolation. The findings of the study show that home smoking bans are not associated with smoker’s physical health and positively correlated with the mental health of the smokers.
U.S. Department of Health and Human Services. (2014). let’s Make the next Generation
Tobacco-Free: You’re Guide to the 50th Anniversary Surgeon. General’s Report on Smoking and Health: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Atlanta.
The report highlights associated dangers to children who are exposed to smoking from Tobacco in the private residences. This study is useful as it gives the necessary data concerning the effects of smoking to children. The data is derived from the findings of the health professionals such as surgeons, and hence valid since it offers first hand findings of the problem. Moreover, the comparative findings from various organizations validate the report for academic and educational purposes.
Thomsom, G., Hudson, S. & Edwards, R. (2010). A qualitative case study of policy maker views
About the protection of children from smoking in cars. University of Otago, Wellington, New Zealand.
The study by Thomson enlightens about policy among process around smoke free car laws. The study aims at evaluating the view of the policy makers on such laws in locations where they are yet to be enacted but published has been completed on the dangers of smoking in cars. This qualitative study is useful in enlightening the public of the prevailing themes of policy maker for the vulnerability of children and necessity of protecting children against second hand smoke.
Wipfi, H. et al. (2008). Second hand Smoke Exposure among Women and children: Evidence
from 31 countries. American Journal of Public Health. 98(4): 672-680
The objective of the study is to define the range of exposure to secondhand smoke among women and children living with smokers around the world and give relevant data to encourage the development of tobacco control policies and intervention in developing countries. Using a cross-sectional survey, the article is useful in informing the reader of the level of SHS among children around the world and especially among the low-income earners. By measuring nicotine concentrations in the hair of children and women living with smokers in the home, the study highlights of the high number of prepared deaths among the affected due to exposure to smoking.
Patterson, c. et al. (2015). A quantitative content analysis of UK newsprint coverage of proposed
legislation to prohibit smoking in private vehicles carrying children. BMC Public Health. 15:760
Patterson underscores SHS as a health risk in UK despite mass media representations of health issues that influence the perceptions of the public. The study is useful in revealing the representations of the problem by the UK national newspapers around proposed legislation to prohibit smoking in private vehicles carrying children. From this article, it is apparent that two lessons that public health advocates may consider: the utility of presenting children as a vulnerable target population, and the possibility of late surges in critical arguments preceding policy events. These findings align with the objectives of the study.
Glover, M., Kira, A. & Faletau, J. (2013). Smoke, smoking and cessation: the views of children
with respiratory illness. Journal of Asthma. 50(7):722-728
This study has been chosen since it is highly useful in the present research. The study explores the attitudes of Maori (indigenous New Zealanders) and Pacific children with respiratory illness towards smoking, secondhand smoke (SHS) and smoking cessation and concludes that even young children from low socioeconomic minority groups are aware of the dangers of smoking and SHS, and hold negative views concerning smoking. This revelation is useful even as policies are to be written since it reveals that majority of, the people are aware of the harm posed to health through smoking. The study further affirms that health promotion messages for parents could have more weight if they convey the concerns voiced by children.
Bell, K. McNaughton, D. & Salmon, A. (2009). Medicine, Morality and Mothering: Public
health discourses on fetal alcohol exposure, smoking around children and childhood Over nutrition. Critical Public Health. 19(2):155-170
Bell, McNaughton, & Salmon highlights issues related to smoking among children. Other than exposing the dangers of smoking in the presence of children at home and in cars, the authors have expounded on the effects of smoking among pregnant mothers. From the study, mothers should realize that when they expose their unborn children to chemicals from smoke, they are participating in child abuse. There is therefore need to focus on maternal responsibility.
Coxhead L. & Rhodes T. (2006). Accounting for risk and responsibility associated with smoking
among mothers of children with respiratory illness. Social Health Illn. 28: 98–121.
The article highlights on the associated dangers of mothers smoking in the presence of their children. This article is useful as it draws the challenges and associated dangers on children who live in los income homes and with limited smoking restrictions. The paper is further useful as it highlights challenges that ought to be considered in determining suitable actions for promoting smoke-free homes at regional and national level.
Mayall B. (2000). Conversations with children: working with generational issues. In: Christensen
P., James A., editors. Research with Children: Perspectives and Practices. London:
Falmer Press; pp. 120–35.
The authors go on to highlight that limited studies have explored on the perceptions of children and their experiences on related issues. The study therefore explores children’s accounts of smoking behavior among family members in the home and car and the consequences of their socio-economic circumstances.
World Health Organization (WHO). (2011). WHO Report on the Global Tobacco Epidemic.
Warning About the Dangers of Tobacco. Geneva: WHO. 2011. Available at: http://
whqlibdoc.who.int/publications/2011/9789240687813 _eng.pdf (accessed 12 August 2013).
WHO is a useful report as it details on the trends of smoking parents and the effected on the children. Besides this, the article emphasizes on the associated dangers and need to avoid smokers and areas they are prone to due to the dangerous chemicals they leave behind and their known harm.
Donnelly P, & Whittle P. (2008). After the smoke has cleared−Reflections on Scotland’s
tobacco control legislation. Public Health. 122(8):762–6.
The study accentuates the opinions of the policy makers in regulating smoke in their private residences and playgrounds in a country that is free of smoke-free laws. Using structured interview on policymakers, the participants think that regulations of smoking on private places is impractical and unwise.
Glover M, (2013). Parent versus child reporting of tobacco smoke exposure at home and in the
car. N Z Med J. 126:1375.
References
Asbridge, M. & Cartwright, J. (2010). The Relationship of Home Smoking Bans to the Physical
and Mental Health of Smokers. Original Investigation. 1-9
Bell, K. McNaughton, D. & Salmon, A. (2009). Medicine, Morality and Mothering: Public
health discourses on fetal alcohol exposure, smoking around children and childhood Over nutrition. Critical Public Health. 19(2):155-170
Coxhead L. & Rhodes T. (2006). Accounting for risk and responsibility associated with smoking
among mothers of children with respiratory illness. Social Health Illn. 28: 98–121.
Donnelly P, & Whittle P. (2008). After the smoke has cleared−Reflections on Scotland’s
tobacco control legislation. Public Health. 122(8):762–6.
Glover, M., Kira, A. & Faletau, J. (2013). Smoke, smoking and cessation: the views of children
with respiratory illness. Journal of Asthma. 50(7):722-728
Glover M, (2013). Parent versus child reporting of tobacco smoke exposure at home and in the
car. N Z Med J. 126:1375.
Mayall B. (2000). Conversations with children: working with generational issues. In: Christensen
P., James A., editors. Research with Children: Perspectives and Practices. London:
Falmer Press; pp. 120–35.
Patterson, c. et al. (2015). A quantitative content analysis of UK newsprint coverage of proposed
legislation to prohibit smoking in private vehicles carrying children. BMC Public Health. 15:760
Ritchie, D., Amos, A., Phillips, R., Cunningham-Burley, S. & Martin, C. (2009). Action to
achieve smoke-free homes- an exploration of experts. BMC Public Health 2009, 9:112
Rouch, G., et al. (2010). Public, private and personal: Qualitative research on policymakers’
opinions on smoke free interventions to protect children in ‘private’ spaces. BMC Public
Health. 10:797
Rowa-Dewar, N., Amos, A. & Cunningham-Burley, S. (2013). Children’s resistance to parents’
smoking in the home and car: a qualitative study. UK Centre for Tobacco and Alcohol Studies, Centre for Population Health Sciences, University of Edinburgh.
Thomsom, G., Hudson, S. & Edwards, R. (2010). A qualitative case study of policy maker views
about the protection of children from smoking in cars. University of Otago, Wellington, New Zealand
U.S. Department of Health and Human Services. (2014). Let’s Make the next Generation
Tobacco-Free: Your Guide to the 50th Anniversary Surgeon. General’s Report on Smoking and Health: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Atlanta.
Wipfi, H. et al. (2008). Second hand Smoke Exposure among Women and children: Evidence
from 31 countries. American Journal of Public Health. 98(4): 672-680
World Health Organization (WHO). (2011). WHO Report on the Global Tobacco Epidemic.
Warning About the Dangers of Tobacco. Geneva: WHO. 2011.