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Association between smoke-free workplace and second-hand smoke exposure at home in India
  1. John Tayu Lee1,
  2. Sutapa Agrawal2,
  3. Sanjay Basu3,
  4. Stanton A Glantz3,4,
  5. Christopher Millett1,2
  1. 1Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK
  2. 2South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
  3. 3Department of Medicine, University of California, San Francisco, California, USA
  4. 4Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
  1. Correspondence to Dr John Tayu Lee, Department of Primary Care and Public Health, School of Public Health, Imperial College, Charing Cross Campus, Reynolds Building, London W6 8RP, UK; t.lee{at}


Background The implementation of comprehensive smoke-free laws has been associated with reductions in second-hand smoke exposure at home in several high income countries. There is little information on whether these benefits extend to low income and middle income countries with a growing tobacco-related disease burden such as India.

Methods State and individual-level analysis of cross-sectional data from the Global Adult Tobacco Survey India, 2009/2010. Associations between working in a smoke-free indoor environment and living in a smoke-free home were examined using correlation at the state level, and multivariate logistic regression at the individual level.

Results The percentage of respondents employed indoors (outside the home) working in smoke-free environments who lived in a smoke-free home was 64.0% compared with 41.7% of those who worked where smoking occurred. Indian states with higher proportions of smoke-free workplaces had higher proportions of smoke-free homes (rs=0.54, p<0.005). In the individual-level analysis, working in a smoke-free workplace was associated with a significantly higher likelihood of living in a smoke-free home (adjusted OR=2.07; 95% CI 1.64 to 2.52) after adjustment for potential confounders.

Conclusions Implementation of smoke-free legislation in India was associated with a higher proportion of adults reporting a smoke-free home. These findings further strengthen the case for accelerated implementation of Article 8 of the Framework Convention on Tobacco Control (FCTC) in low and middle income countries.

  • Public policy
  • Low/Middle income country
  • Smoking Caused Disease

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