Factors related to caregivers' risk perception of secondhand smoke exposure on children's health

Home is one of the main places for children's secondhand smoke (SHS) exposure. The implementation of smoke-free rules at home might be influenced by caregivers' risk perception of SHS exposure. This study aimed to analyze factors related to caregivers' risk perception of SHS exposure in children.

We conducted a cross-sectional telephone survey among a representative sample of 2411 parents or legal guardians of children aged <12 years in Spain in 2016. The main study variable was caregivers' healthrisk perception of SHS exposure on children. We investigated correlates of risk perception using multivariate Poisson regression models with robust variance.

Overall, 59.6% reported SHS exposure negatively affects children's health a lot, while 34.1% that it affects quite a bit, and 5.5% and 0.8% a little bit or not at all, respectively. The factors associated with a higher caregivers' risk perception were high education level (adjusted prevalence ratio, APR=1.11; 95% CI: 1.01-1.24), living in a non-smoking family unit (APR=1.17; 95% CI: 1.07-1.27), in a home with smoke-free rules (APR=1.34; 95% CI: 1.19-1.51), and with girls only (APR=1.14; 95% CI: 1.06-1.22).

Caregivers' risk perception of SHS exposure is influenced by social determinants and smoking habits in family units. These findings support the need for interventions with a social equity perspective to reduce children's SHS exposure.