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Abstract: The aim of this collaborative public health study was to engage families, agencies, and programs in reducing secondhand smoke exposure in Central Harlem, New York City. Baseline interviews (n=657) and focus groups (n=4) were conducted with adult members of households with children who had asthma and asthma-like symptoms in the Harlem Children's Zone Asthma Initiative. The interviews concerned the prevalence and determinants of exposure of enrolled children to secondhand smoke. Key findings were that participants: (1) were generally aware of the hazards of secondhand smoke; (2) used strategies to reduce exposure to secondhand smoke in their homes; (3) believed that outdoor pollutants are sometimes just as bad for the health of their children as secondhand smoke; and (4) used smoking to provide stress relief and help diffuse otherwise volatile situations in their homes. The Harlem Smoke-Free Home Campaign was launched in October 2007 based in part on these findings.
Key words: Secondhand smoke, asthma, child health, respiratory health, health disparities, African American health, health policy.
United States public health agency leaders have emphasized the importance of reducing secondhand smoke exposure for improving population health. On June 27, 2006, Vice Admiral Richard H. Carmona, MD, MPH, FACS released a report titled, The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.1 This comprehensive scientific report, prepared by the Office on Smoking and Health (OSH) at the Centers for Disease Control and Prevention (CDC), reaffirmed and strengthened the findings of the landmark 1986 Surgeon General's report, The Health Consequences of Involuntary Smoking.2 In this paper, in accordance with the new report,1 the term secondhand smoke is used to capture the involuntary nature of the exposure (which environmental tobacco smoke fails to do).1
Thomas R. Frieden, MD, MPH, the Commissioner of the New York City Dept. of Health and Mental Hygiene, has argued that one of the myths undermining tobacco control is that secondhand smoke may be a nuisance, but it isn't deadly.3 Both the 1986 and the 2006 reports of the Surgeon General on involuntary smoking resolutely dispel this myth.1,2
In 2002, New York City began implementing a comprehensive tobacco control strategy that led to an 11% decrease in smoking prevalence among adults over the following year (from 21.6% to...