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levels, meanwhile, have enacted or approved legislation prohibiting smoking in vehicles in which a child is present (Belluck 2007; OTRU 2006).

Reducing Smoking

Not only do household bans benefit children by reducing the adverse health effects from secondhand smoke exposure, but they also lead to reduced smoking and increased cessation by adults as well. Farkas and colleagues have conducted two studies that demonstrate this effect. Smokers who lived under a total smoking ban were more likely to report a quit attempt in the previous year, and those who made quit attempts were less likely to relapse (Farkas et al. 2000). In fact, smoke-free homes are associated with lower rates of smoking prevalence than smoke-free workplaces (Bonta, Appendix B). Similarly, a survey of Oregonians found that a full household smoking ban resulted in a doubling of the odds of a subsequent quit attempt and that for those contemplating a quit attempt (i.e., those with an intention to quit within the next month), a full ban led to a lower relapse rate (Pizacani et al. 2004). Further evidence from a survey of high school students indicates that a more restrictive home smoking policy is associated with a greater likelihood of being in an earlier stage of smoking uptake and a lower 30-day smoking prevalence (Wakefield et al. 2000). The results of studies of households with smoking bans in Australia have been even more dramatic: the odds of quitting smoking were found to be 4.5 times greater in households with a smoking ban (Siahpush et al. 2003). This evidence suggests that the social context of smoking is an important factor for smokers and that eliminating smoking from the living environment increases the rate of smoking cessation.

Reducing Initiation

Household smoking bans also have the effect of reducing smoking among youth, as the effects of parents as role models appear to be a major factor in determining children’s future smoking behavior. Studies indicate that 12-year-old children of parents who smoke are roughly twice as likely to begin smoking between the ages of 13 and 21 years as those whose parents do not smoke. Also, in addition to less smoking by parents, stricter family monitoring and rules regarding smoking were related to a lower risk of smoking initiation (Hill et al. 2005). Farkas and colleagues found that adolescents age 15 to 17 years were 74 percent less likely to be smokers if they lived in houses with smoking restrictions (Farkas et al. 2000). Other studies have verified that strong home smoking bans are associated with lower rates of smoking uptake, prevalence, and consumption among teenagers (Wakefield et al. 2000). A panel convened in June 2006 by NIH found in its review of the scientific literature on tobacco use that clean indoor air policies and laws regulating exposure to tobacco smoke have indeed proven

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