Developing a harm reduction approach to protect disadvantaged children from second-hand smoke: A qualitative study with parents and practitioners.

Citation

O'Donnell R, Rowa-Dewar N, Lumsdaine C, Di Tano G, Swanston L & Lewis G (2019) Developing a harm reduction approach to protect disadvantaged children from second-hand smoke: A qualitative study with parents and practitioners.. 6th World Social Marketing Conference, Edinburgh, UK, 04.06.2019-05.06.2019. https://wsmconference.com/edinburgh-2019/programme

Abstract
Enabling parents to create a smoke-free home is one of the key ways that children's exposure to second-hand smoke (SHS) can be reduced globally. SHS is a significant risk to child health, linked to a range of illnesses and conditions including asthma, and SIDS (Sudden Infant Death Syndrome). The Scottish Government’s 2020 target to reduce children’s SHS exposure by 50% (from 11% to 6%) has been reached early. However, SHS exposure remains a significant risk to children living in disadvantaged homes, who are 12 times more likely to be exposed to SHS in the home compared to children living in more affluent areas. While most parents try to protect their children from SHS, disadvantaged parents with young, mobile children and limited access to outdoor space at home find it particularly challenging to smoke outside. Many use ineffective solutions, such as limiting smoking on one room only, or smoking near an open window. Innovative, empowering approaches are needed to address this inequality and support parents to create and maintain smoke-free homes. This study, which ends in July 19, explores the feasibility of providing parents with the support and access to NRT for temporary use provided by two local pharmacies to help them protect children from SHS in the home. Thirty five parents living in Edinburgh and the Lothians who currently smoke in their home with young children present expressed an interest in taking part in the study. Sixteen of these parents attended an appointment with an NHS smoking cessation advisor to discussed Nicotine Replacement Therapy (NRT) options suitable for temporary abstinence from smoking in the home with them. NRT was provided for up to 12 weeks by local participating pharmacies, with ongoing expert advice available from pharmacy staff. Qualitative interviews with staff and parents explored the feasibility, cost and impact of using NRT in the home to protect children from SHS exposure. findings suggest that parents who use NRT to create a smoke-free home experience other positive consequences - reducing their cigarette consumption by up to 50%, and saving money. However, barriers to accessing NRT include existing poor relationships/negative interactions with pharmacy staff, pregnancy, moving out of the area and other stressful life events. The implications of these findings for future intervention development will be discussed.