Brief Interventions to Create Smoke-Free Home Policies in Low-Income Households

The burden of tobacco use falls disproportionately on low-income populations, through high
rates of primary smoking and exposure to secondhand smoke. The remarkable progress in
creating smoke-free environments in the U.S. over the past two decades has left smoker's
homes as one of the primary sources of exposure to secondhand smoke for both children and
nonsmoking adults. Intervention research that identifies effective and practical strategies
for reaching the minority of households that still allow smoking in the home has
considerable potential to reduce smoke exposure, but suitable channels to reach low-income
families are limited. The proposed research will develop, evaluate and disseminate a brief
smoke-free homes intervention through the established national infrastructure of 2-1-1 call
centers. 2-1-1 is a nationally designated 3-digit telephone exchange, similar to 9-1-1 for
emergencies or 4-1-1 for directory assistance, that links callers to community-based health
and social services.

The proposed research has four specific aims: 1) Conduct formative research on intervention
messages and materials for promoting smoke-free homes in low-income populations, applicable
to both smokers and nonsmokers as household change agents; 2) Conduct a randomized
controlled trial in the Atlanta 2-1-1 service area to evaluate the efficacy of a brief
intervention to create smoke-free homes among 2-1-1 callers; 3) Conduct replication studies
in Houston and North Carolina 2-1-1 systems to systematically test the intervention in
varied populations and tobacco control climates, and 4) Disseminate the research-tested
smoke-free homes intervention through a variety of mechanisms including a national grants
program to 2-1-1 systems and through the Tobacco Technical Assistance Consortium's linkages
to the state and local tobacco control infrastructure in the U.S.