Parental Risk Perceptions of Child Exposure to Tobacco Smoke

Laura Rosen; Inessa Kostjukovsky


BMC Public Health. 2015;15(90) 

In This Article


Despite the accumulated evidence of harm to children from tobacco smoke exposure (TSE),[1,2] roughly 40% of children worldwide are exposed to tobacco smoke in their homes.[3] Infants are perhaps the most vulnerable to harm: captive smokers in their own homes, with their small bodies and developing lungs, they are at increased risk of sudden infant death syndrome, acute respiratory infections, lower respiratory illness, acute and recurrent otitis media and chronic middle ear effusion, onset of wheeze illnesses, cough, phlegm, wheeze, breathlessness, asthma diagnosis, continued adverse effects on lung function, and delayed lung maturation.[1]

The primary source of young child exposure and of exposure-related harm to the child is smoking in the child's home.[4] The phenomenon of parents either causing harm to their own children by smoking around them in their homes, or of allowing others to harm them by smoking in their presence, is inherently puzzling. One possible explanation for this phenomenon is that parents underestimate risks associated with child TSE, and therefore don't protect them. This would be consistent with the approach of the Health Belief Model (HBM), which posits that "the perceptual world of the behaving individual" is related to preventive health behaviors. In the HBM formulation, susceptibility to harm and severity of harm are two critical dimensions of health perceptions.[5] These dimensions are thought to be at least partially dependent on knowledge.[5] More recently, a third dimension, likelihood of harm, has been identified.[6] Risk perceptions regarding various types of health behaviors -- for example vaccinations, fruit intake, dental checkups, and drinking and driving -- have been addressed by researchers using some of these dimensions.[6,7] Though research has been conducted on the relationship between risk perceptions, knowledge, and passive smoking,[8–17] research exploring dimensions of risk perceptions[6] has not, to the best of our knowledge, been conducted for the field of child TSE.

The goals of this study were to 1 - pilot a method for measuring Parental Risk perceptions of Exposure to Tobacco Smoke (PRETS), using established dimensions of risk perception; 2- identify correlates of PRETS, and 3- explore the relationship between PRETS, parental smoking status, and family smoking in the home. We hypothesized that PRETS were associated with parental smoking status and family smoking in the home.