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Second-hand smoke exposure and mitigation strategies among home visitation workers
  1. Robyn R Keske1,
  2. Vaughan W Rees1,
  3. Ilan Behm1,
  4. Brianna M Wadler2,
  5. Alan C Geller3
  1. 1Center for Global Tobacco Control, Department of Society, Human Development and Health, Harvard School of Public Health, Boston, USA
  2. 2Center for Community-Based Research, Dana Farber Cancer Institute, Boston, USA
  3. 3Department of Society, Human Development and Health, Harvard School of Public Health, Boston, USA
  1. Correspondence to Dr Vaughan W Rees, Center for Global Tobacco Control, Harvard School of Public Health, Landmark Building, Level 3 East, 677 Huntington Ave, Boston, MA 02115, USA; vrees{at}


Objectives Protection of workers from second-hand smoke (SHS) in occupational settings is an important policy priority, yet little attention has been given to SHS protection for home visitation health workers, who number almost 2 million in the USA. Self-reported SHS exposure, SHS mitigation strategies and suggestions for further SHS exposure reduction approaches were obtained from home visitation health workers in Massachusetts.

Methods A cross-sectional survey was conducted among Massachusetts Early Intervention workers (N=316) at their state-wide conference in April 2010.

Results Eighty-three per cent of respondents reported at least 1 hour per month of SHS exposure, and 16% reported at least 11 hours per month. Nevertheless, only 22% of workers counselled clients on maintaining a smoke-free home. Fewer than 30% of workers had ever voiced concerns to their employing agency, and just 12% had raised their concerns directly with clients. Only 14% stated that their agency had rules designed to protect workers from SHS.

Conclusions SHS exposure occurs frequently among home visitation health workers. The data point to a substantial population who are not protected from SHS exposure by formal policies.

  • Second-hand smoke
  • exposure
  • self-report
  • workplace
  • home
  • addiction
  • tobacco products
  • environmental tobacco smoke
  • harm reduction
  • smoking topography
  • surveillance and monitoring
  • public policy
  • tobacco industry
  • smoking-caused disease
  • cessation
  • disparities
  • priority/special populations
  • socioeconomic status

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  • Funding This study was supported by National Institutes of Health/National Institute on Minority Health and Health Disparities, grant R24-MD-002772.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Harvard School of Public Health's Office of Human Research Administration.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Final deidentified research data are available for sharing as per National Institutes of Health data sharing policy. Data will be made available to qualified researchers upon application to the Principal Investigator.