Summary: | Background
Around 40% of children worldwide are exposed to tobacco
smoke by their parents. Interventions to reduce exposure have limited success.
Parental reports often do not match biomarker reports of children's
exposure. We propose there may be a
fundamental misunderstanding among smoking parents as to what exactly exposure
is and in what circumstances exposure occurs.
We aimed to develop and validate a
tool to assess and quantify parental perceptions of exposure (PPE) regarding
children´s exposure to tobacco smoke.
Methods
Qualitative research with smoking parents revealed
common misperceptions: eg. exposure is avoided when smoking at the window,
with a child in stroller, or in the car before collecting children. A model was
developed and a questionnaire constructed using pictures and vignettes of
different situations in which children are exposed to smoking. Parents rated
exposure of a hypothetical child in each situation on a scale of 1-7.
Psychometric properties were assessed including exploratory factor analysis,
test-retest reliability and Cronbach's alpha coefficient.
Results
220
parents completed the questionnaire. Factor analysis produced 6 factors for
parental perceptions of exposure (PPE), explaining a cumulative total variance
of 76.3%. Factors were named: 1)secondhand exposure; 2)thirdhand exposure; 3)knowledge/certainty;
4)sensory perceptions; 5)time; 6)distance.
Test-retest showed high correlations of PPE: r=0.856, p< 0.001.
Correlation between PPE and parental risk perceptions (PPR) was significant (0.766
p< 0.001). Smokers scored significantly lower than non-smokers on PPE and PPR
signifying a narrower definition of exposure, definition of fewer situations as
involving greater exposure, and attaching less risk to these situations
(p< 0.001).
Conclusions
The PPE tool was demonstrated as valid and reliable.
Smokers and non-smokers had different perceptions of exposure. This tool can shed
light on parents' smoking behaviour around their children, may explain
discrepancies between parental and objective reports of exposure and may
ultimately help change parental smoking behaviour by altering parental
perceptions of exposure. [Excerpt from Parental Perceptions of Exposure tool]
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