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Parental Knowledge, Attitude, and Practice on Tobacco Use, Smoking Cessation, and Children's Environmental Tobacco Smoke Exposure.

ABSTRACT: Background: Environmental tobacco smoke (ETS) exposure in children ranks one of the major public health problems in our time. Poor parental knowledge, attitude, and practice (KAP) on ETS often contribute to worse exposure of the kids. Thus, we aimed to document parental KAP regarding tobacco use, smoking cessation and children's ETS exposure, and to analyse how knowledge and attitude relate to practice. Methods: Self-administered KAP questionnaires were distributed to smoking parents recruited from the pediatric unit at the Prince of Wales Hospital, which provides pediatric service to a population of 1.2 million in Hong Kong. The 60-item questionnaire had a range of 0-38 for knowledge, 0-44 for attitude, and 0-40 for practice. Descriptive analyses were performed for KAP response, regression analyses were performed for the exploration of associations and identification of predictive indicators. Results: 145 smoking parents (mean age: 38.0 ± 6.7 yrs.; male: 85.5%) were included. Less than half (39.3%) of them reported a smoke-free policy at home. Among those parents who had private cars, less than half (45.2%) of them had smoke-free policy in their car that they never smoked in the car. Only 25.5% of the participants correctly answered ≥70% of the knowledge questions, and 11.8 % of the participants gave favorable responses to ≥70% of the attitude questions. The total knowledge and the total attitudes score were positively associated (r = 0.49, 95% CI: 0.35-0.79, p < 0.001), yet they were only modestly correlated with parental practice on children's ETS exposure. By multivariate regressions, potential predictive factors for more favorable parental KAP included higher household income, lower parental nicotine dependence level and breastfeeding practice. Conclusions: Parental KAP related to tobacco use and children's ETS exposure needs improvement to address the significant gap between recommended and actual practice. The weak association between knowledge and practice suggested that parental education alone is not adequate to combat ETS exposure in children.

SUBMITTER: Dai S

PROVIDER: S-EPMC8653904 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:It is estimated that around 40% of children worldwide are exposed to tobacco smoke, largely by their parents. Discrepancies between biochemical measures of exposure and parental report imply that parents may be under-reporting children's exposure. Previous research has shown that there may be a fundamental misunderstanding among smoking parents as to what exactly exposure is and in what circumstances it occurs.We aimed to develop and validate a measure to assess parental perceptions of exposure (PPE) regarding child tobacco smoke exposure (TSE). A model was developed based on a qualitative study of smoking parents and a questionnaire constructed using pictures and vignettes to assess parental rating of children's exposure in hypothetical situations. The questionnaire was completed online by 220 Israeli parents recruited via social media. Exploratory factor analysis was performed, and reliability and internal consistency were assessed using test-retest reliability and Cronbach's alpha coefficient.Factor analysis produced 6 factors for PPE which explained a cumulative total variance of 76.3%. Factors were termed: 1) second-hand exposure; 2) third-hand exposure; 3) perceived knowledge/certainty; 4) sensory perceptions; 5) time perceptions; and 6) distance perceptions. All sub-scales showed good internal consistency and variance. Test-retest reliability was high (r?=?0.856, p?=?.001). Total PPE score and subscales were highly correlated with risk perceptions r?=?0.766. Smokers scored significantly lower on PPE than non-smokers, defining fewer situations as involving greater exposure (p?<?0.001). Logistic regression showed PPE was able to discriminate smoking status.Results provide supporting evidence for the PPE as a reliable and valid construct, which can be feasibly measured. Smokers perceived exposure less frequently than non-smokers. This new measure can shed light on parental smoking behaviour and may help us to increase parental awareness of exposure in order to potentially reduce children's exposure to tobacco smoke.

Project description:Background:Workplace smoking cessation (SC) intervention is effective in increasing quit rate but little was known about the factors associated with voluntary SC promotion. Comprehensive smoke-free legislation, including banning smoking in all indoor area of workplaces, has been enforced in Hong Kong. This survey investigated the prevalence of company's compliance with smoke-free legislation and examined the relation between voluntary SC promotion in workplace and employer's knowledge of and attitude towards smoking and SC. Methods:Half (50.3%, n = 292) of a convenience sample of companies completed a self-administered questionnaire on company's voluntary SC promotion in the workplace. Factors investigated included company's characteristics (size, type, and number of smoking employees); employers' knowledge of smoking, second-hand smoke and SC effects on health; perceived responsibility in assisting employees to quit smoking and smoking prohibition in workplace (smoke free policy). Logistic regression yielded adjusted odds ratio (aOR) for voluntary SC promotion. Results:A notable proportion of companies (14.7%) showed non-compliance with the smoke free workplace ordinance and only 10% voluntarily promoted SC. Perceived greater negative impact of smoking on the company (adjusted odds ratio[aOR] 1.94, 95% confidence interval [CI] 1.18-3.20) and better knowledge of smoking (aOR 1.40, 95%CI 1.00-1.94) were associated with voluntary SC promotion. Positive but non-significant associations were observed between perceived responsibility of assisting employees to quit, workplace smoke free policy and voluntary SC promotion. Company characteristics were generally not associated with voluntary SC promotion except white collar companies were less likely to promote SC (aOR 0.26, 95% CI 0.08-0.85). Conclusions:This is the first survey on company's SC promotion in the Chinese population. A notable proportion of companies was not compliant with the smoke-free workplace ordinance. Employers with a higher level of knowledge and perceived impact of smoking on companies and from blue-collar companies were more likely to promote SC in workplace. The findings inform future workplace intervention design and policy. Trial registration:The study was retrospectively registered at ClinicalTrials.gov (NCT02179424) dated 27 June 2014.

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Parental Knowledge, Attitude, and Practice on Tobacco Use, Smoking Cessation, and Children's Environmental Tobacco Smoke Exposure.

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