Impact of National Smoke-Free Legislation on Educational Disparities in Smoke-Free Homes: Findings from the SIDRIAT Longitudinal Study

Abstract

Families with lower socioeconomic status are less likely to adopt household smoking bans (HSB). The aim of this study was to determine whether socioeconomic disparities in HSB prevalence in Italy decreased 7–9 years after the introduction of the Italian ban on smoking in public places. A longitudinal, 12-year, two-wave study was conducted on a sample of 3091 youths aged 6–14 years in 2002; 1763 (57%) were re-interviewed in 2012–2014. A Poisson regression with a robust error variance was used to assess the association between socioeconomic disparities and HSB prevalence. The adoption of HSBs significantly increased from 60% in 2002 to 75% in 2012–2014, with the increase recorded in youths with ≥1 smoking parent only (from 22% at baseline to 46% at follow-up). The presence of HSBs at baseline was more likely in families with ≥1 graduate parent compared to those with no graduate parents (prevalence ratio (PR) = 1.34, 95% confidence interval (CI) = 1.15–1.57), either in families with ≥1 smoking parent (PR = 1.36, 95% CI = 1.17–1.58) or in families with non-smoking parents (PR = 1.61, 95% CI = 1.01–2.56). Conversely, at follow-up socioeconomic disparities dropped since families with no graduate parents were 1.5-fold more likely to introduce a HSB between the two waves. The Italian ban on smoking in public places may have increased the adoption of smoke-free homes in families with smoking and non-graduate parents, causing the drop of the socioeconomic gap in smoke-free homes.