Secondhand smoke avoidance by preteens living with smokers: to leave or stay?

Secondhand smoke (SHS) is hazardous to children's health. Designing interventions to reduce exposure requires understanding children's behavior in the presence of smokers, yet little is known about this behavior.

To determine whether children's avoidance of SHS is associated with lower exposure and to explore predictors of avoidance based on a behavioral ecological model.

Preteens aged 8-13 (N=358) living with a smoker identified their primary source of SHS exposure, and reported whether they left (avoided exposure) or stayed the last time they were exposed to that person's smoke. The SHS avoidance measure was validated by examining associations with SHS exposure. Multiple Logistic Regression was used to determine predictors of SHS avoidance.

Based on urine cotinine and reported exposure, preteens who left the presence of SHS had lower exposure than those who stayed. Preteens were more likely to leave SHS if they were less physically mature, had not tried smoking, had a firm commitment not to smoke, did not assist family smoking, had family/friends who discouraged breathing SHS, or had friends who disliked smoking.

Most SHS exposure reduction interventions have targeted changes in smokers' behavior. Reductions can also be achieved by changing exposed nonsmokers' behavior, such as avoiding the exposure. Future studies should measure young people's SHS avoidance and test interventions to increase their avoidance practices.