Single-parent status and smoke-free home rules among daily smokers

In Canada, the home has become the primary locale in which children are exposed to tobacco smoke. Single parents are less likely than two-parent families to ban smoking at home, but the extent to which this relates to economic inequalities across family structures is unclear. Our objective was to estimate the association between household structure (single- vs. non-single-parent family) and smoke-free home rules, accounting for indicators of economic disadvantage.

Data were available in a telephone survey conducted in 2011-2012 in Québec, Canada, of 567 daily smokers (mean (SD) age 38.3 (8.1); 56.6% female) who lived with children. Poisson regression models with robust variance were used to determine whether single-parent status was independently associated with living in a smoke-free home after accounting for age, sex, language, household size, age of youngest child, neighbourhood material deprivation, socio-economic status and employment status.

Of 122 participants living in a single-parent family, 33 (27%) reported that their home was smoke-free, compared with 250 of 445 participants (56.2%) living in non-single-parent families. Single parents were approximately 40% less likely to live in smoke-free homes than other daily smokers, even after accounting for indicators of economic disadvantage.

Single parents, regardless of income or level of neighbourhood material deprivation, were less likely to report smoke-free home rules. These smokers represent a distinct subgroup that warrants targeted interventions to help them implement such rules by addressing their specific needs against a backdrop of creating more equitable access to the social determinants of health.