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A campaign to protect children from environmental tobacco smoke (ETS) has achieved a significant level of behaviour change by smoking parents. The “Car and home: smoke free zone” campaign resulted in a 55.7% increase in the number of reported smoke-free homes occupied by smokers with children aged under 6. There was also a 41.8% increase in the number of reported smoke-free cars.
ETS exposure can cause children problems from asthma, lower respiratory tract infections such as pneumonia and bronchitis, coughing, wheezing, middle ear infections, and sudden infant death syndrome (SIDS). It has also been linked to an increased risk of bacterial meningitis, learning difficulties, autism, behavioural problems, and heart disease.
The ETS and Children Project was launched in 2002 in New South Wales (NSW) to limit the exposure of children aged 0–6 to ETS in the car and home environment. Campaign activity was funded by a $A2.4 million (US$1.8 million) grant from the NSW Department of Health and was run by a taskforce of government and non-governmental organisations (NGOs). The main message of the campaign was summarised in the slogan “Car and home: smoke free zone” and parents and carers were asked to make their homes and cars smoke-free by going outside if they needed to smoke and by asking visitors to do the same.
Resources were developed to deliver the campaign message in English and a number of local community languages, which were reinforced in three mass media campaigns. Commercials aired all over the state on television and radio, supported by billboards and stories and features in newspapers and magazines. Health professionals and childcare workers were also targeted, to encourage them to include information about the health risks of ETS in their discussions with parents who smoke. This helped spread the message among the target audience, as well as increasing the sustainability of the campaign message beyond the project’s lifespan.
Although smoking rates continue to decline in NSW (the daily rate is 17.2% for males and 15.8% for females), rates for Aboriginal and other culturally and linguistically diverse groups remain much higher. It was a priority for the project to reach these groups, in view of their children’s ETS exposure being correspondingly high, too.
A community grants scheme enabled local groups to conduct culturally appropriate projects within their own communities. The funding for each group varied according to the scope and size of their proposal and the type of activity they wished to undertake, and ranged from $A4850 to $A30 000 (US$3600–22 500). Applicants for the grants were required to work with at least one of the organisations represented on the taskforce, which led to the formation of strong networks.
Some grants translated existing resources into community languages with the result that information is now available in Arabic, Assyrian, Bosnian, Croatian, Farsi, Greek, Khmer, Italian, Mandarin, Samoan, Serbian, Spanish, Tongan, and Vietnamese. Some grant recipients adapted resources to ensure that they were both linguistically and culturally appropriate for their community. For example, the issue of hospitality was seen as a potential barrier to making the home smoke-free for some Arabic speaking people, as they did not want to offend visitors by asking them to smoke outside. The slogan developed by this language group focused on this issue “Your visit benefits us, but your smoke harms us”. Another grant targeting Pacific Islander groups found that the campaign slogan conveyed a different meaning to the one intended. For some of the Samoan language groups “Car and home: smoke free zone” was taken literally, meaning, “This is an area where you are free to smoke”. The resource developed for this community used the slogan “Smoking makes kids sick. Smoke outside your home and car”. Culturally specific resources were also developed for use by Aboriginal communities, including professional development material for Aboriginal health workers.
The campaign has been rigorously evaluated. By the end of the campaign period 73% of homes with a smoker and children aged 0–6 years reported being totally smoke-free with a further 18% reporting they did not smoke when their children were in the same room. This is considered a great result and a good example of what can be achieved when government and NGOs work together. It is also encouraging to see those parents and carers who are unable to quit, change their smoking behaviour to protect the health of their children.