Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug 20;18(1):1031.
doi: 10.1186/s12889-018-5928-1.

Parental perceptions of children's exposure to tobacco smoke: development and validation of a new measure

Vicki Myers  1 , Shoshana Shiloh  2 , Laura Rosen  3
Affiliations

Parental perceptions of children's exposure to tobacco smoke: development and validation of a new measure

Vicki Myers et al. BMC Public Health. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Children; Parents; Perceptions; Secondhand smoke; Tobacco smoke exposure; Validation study.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Tel Aviv University Institutional Ethics Committee. The questionnaire started with a statement of consent which participants had to agree to before proceeding to complete the questions.

Consent for publication

The people depicted in the images in Fig. 2 and the Supplementary material are the author (VM) and her children and consent for publication is given.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Conceptual model: Parental perceptions of children’s exposure to tobacco smoke. [Reprinted from Rosen et al. Parental Perceptions and Misconceptions of Child Tobacco Smoke Exposure, Nicotine & Tobacco Research 2017 doi: 10.1093/ntr/ntx169 by permission of Oxford University Press (licence no. 4399291196149)]
Fig. 2
Fig. 2
Example items from the PPE tool
Fig. 3
Fig. 3
Scatterplot of the correlation between PPE and PPR
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Mbulo L, Palipudi KM, Andes L, Morton J, Bashir R, Fouad H, et al. Secondhand smoke exposure at home among one billion children in 21 countries. Tob Control. 2016;25:e95–100. doi: 10.1136/tobaccocontrol-2015-052693. - DOI - PMC - PubMed
    1. Oberg M, Jaakkola MS, Woodward A, Peruga A, Pruss-Ustun A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377(9760):139–146. doi: 10.1016/S0140-6736(10)61388-8. - DOI - PubMed
    1. Rosen LJ, Myers V, Hovell M, Zucker D, Ben NM. Meta-analysis of parental protection of children from tobacco smoke exposure. Pediatrics. 2014;133(4):698–714. doi: 10.1542/peds.2013-0958. - DOI - PubMed
    1. DH&H. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2006. - PubMed
    1. Raghuveer G, White D, Hayman LL, Woo JG, Villafane J, Celermajer D, et al. Cardiovascular consequences of childhood secondhand tobacco smoke exposure: prevailing evidence, burden, and racial and socioeconomic disparities a scientific statement from the American Heart Association. Circulation. 2016;134(16):e336–e359. doi: 10.1161/CIR.0000000000000443. - DOI - PMC - PubMed

Publication types

Substances