Household environments & cessation history, plans & self-efficacy among low-income
smokers
Objective: Low-income smokers face numerous barriers to quitting smoking that include hurdles
at the individual level (e.g. lack of knowledge about evidence-based tobacco treatment) and
environmental factors (e.g. broader community norms, social circle factors that may subtly
discourage quitting). Despite these barriers, low-income smokers’ household environments
could facilitate quitting by making it seem possible, desirable, and thus something to strive for.
We sought to examine how home smoking rules and other household members’ smoking
behaviors related to low-income smokers’ past quit attempts, readiness to quit, and self-efficacy
to quit.
Methods: OPT-IN was a randomized controlled trial of proactive tobacco cessation outreach.
The study recruited adult smokers age 18-64 from the administrative databases of the statesubsidized Minnesota Health Care Programs. The present analysis used data from OPT-IN’s
baseline survey, which was completed by 2406 participants and conducted in 2011/12. We
tested household environmental factors’ associations with past-year quit attempts, readiness to
quit, and quitting self-efficacy in minimally adjusted (race, education, income, age, gender) and
fully adjusted (additional adjustment for time to first cigarette and cigarettes per day) regression
models.
Results: Smokers who lived in homes with more restrictive household smoking policies were
more likely to report having made a quit attempt in the past year, had greater readiness to quit,
and greater self-efficacy related to quitting (all p<0.05) (however the association with past-year
quit attempts was not significant in the fully adjusted model). Having more friends and family
who smoke was associated with lower readiness to quit (p<0.05) but was not related to pastyear quit attempts or quitting self-efficacy. Having one or more household members who smoke
was not related to any of the outcomes examined.
Conclusions: The relationship between household smoking policies and the cessation-oriented
outcomes suggests that pro-quitting adjustments to household environment could be
accomplished though household policy change, even in the presence of other household
members who are smokers.