The influence of health messaging source and frequency on maternal smoking and child exposure among low-income mothers

Abstract

Addressing maternal smoking and child tobacco smoke exposure (TSE) remains a public health priority, particularly in low-income, underserved populations which are known to experience the highest TSE rates and tobacco-related morbidity/mortality. Little is known about the types of TSE messaging received in high-risk populations, and which communication channels are influential in promoting smokers’ efforts to protect children from TSE. The purpose of this study was to examine associations between reported sources and frequency of TSE-reduction health messages maternal smokers received and the effects of the messaging on smoking- and TSE-reduction-related behaviors. Maternal smokers from low-income communities in Philadelphia, Pennsylvania who were enrolled at baseline in the Family Rules for Establishing Smokefree Homes trial (N = 359) were included in this study. Each participant completed a 60-minute in-home baseline interview, which included questions about their smoking history, current smoking patterns, children's TSE, and the TSE-related health messaging they had received prior to enrollment. Multivariable analyses were conducted to determine the effect of the source messaging on mothers’ knowledge, behavior, and intention regarding their baby's TSE. Results suggest that different sources of messaging may differentially impact smoking behavior and intention to change. For example, messaging from healthcare and dental providers may influence efforts to protect children from TSE whereas friends and family may influence intention to quit. Future studies could examine the value of multilevel health communication strategies, utilizing advice from healthcare providers that is augmented by family and peers to help promote smoking behavior change in this high-risk group of underserved postpartum smokers.

Keywords:

• Secondhand smoke
• Health communication
• Passive smoking

Acknowledgements

The authors would also like to thank many students and staff who helped with this study, including: Katherine DiSantis, Ph.D., MPH, James Kingham, MA, Natalie Tolley, Ph.D., MPH, and Jamie Dahm.

Disclaimer statements

Contributors A.L. contributed to the writing and data analysis; U.N. contributed to the writing of the paper and conduction of the study; S.B.B. contributed to the writing of the paper; B.C. contributed to the writing and mentorship guidance for this paper.

Conflicts of interest The authors have no conflicts of interest to declare.

Ethics approval The original FRESH study was approved by the Temple University Institutional Review Board.

Additional information

Funding

This study was supported by grants from the National Cancer Institute at the NIH to B. Collins (CA105183 and CA93756).

Notes on contributors

Amy M. Lavery

Dr Amy Lavery, graduated from Temple University with a doctorate in public health. Her dissertation focused on the health effects of tobacco smoke exposure in children.

Uma S. Nair

Dr Uma S. Nair is an Assistant Professor at the Mel and Enid Zuckerman College of Public Health at The University of Arizona. She previously worked as an Assistant Director at Temple University where she helped launch the FRESH study.

Sarah Bauerle Bass

Dr Sarah Bauerle Bass is an Associate Professor and Director of the Risk Communication Laboratory at Temple University. She has over twenty years of experience and training in communication message development and her research utilizes commercial marketing techniques to enhance patient decision making.

Bradley N. Collins

Dr Bradley Collins was trained as a clinical psychologist with research expertise in health psychology and substance dependence treatment. Dr. Collins directs the Health Behavior Research Clinic, maintaining an active research program that includes collaborative projects among faculty and students across departments and colleges at Temple University.