Recent research has highlighted that smoking in cars is a source of significant second-hand smoke exposure for children leading to calls from health groups for the introduction of laws to ban smoking in vehicles in which children are passengers.1,2 There has, however, been considerable debate about the merits of legislation versus public education on the issue.
In 2007 and 2008, the Cancer Council Western Australia received a boost in funding from the Western Australian Department of Health to run a series of media campaigns drawing attention to the health effects of second-hand smoke and addressing common myths and misconceptions about how to protect children from exposure to it. The main message of the campaigns was ‘Make your home and car smoke-free’. The campaigns achieved some positive results with parents interviewed post-campaigns taking extra care to protect their kids from exposure to second hand smoke and, in some cases reducing or quitting smoking altogether.
Prior to the campaigns, parents who smoked were surveyed (n=101). A minority (9%) claimed to smoke inside their homes but a much higher proportion (50%) reported smoking inside vehicles regardless of whether children were present leaving greater scope for behavioural change.3 Surveys of parents who smoked conducted after each wave of media advertising (n=194; n=193; n=200) found a drop in reported smoking in vehicles ‘at all’ compared to 50% pre-campaign (wave 1: 37%; wave 2: 40%; wave 3: 44%).3,4 The differences in these proportions in the three waves were not statistically significant (p>0.05). Behaviour change of this order, particularly that seen after the first wave of advertising, is unusual for public education campaigns given the limited budgets. Consistent with data on smoking behaviour in the home, the vast majority of respondents did not allow smoking inside the vehicle when non-smokers were present (wave 1: 88%; wave 2: 86%; wave 3: 84%), especially children (wave 1: 95%; wave 2: 94%; wave 3: 92%).4 There were no significant differences in these proportions in the three waves.
Nonetheless, evaluation of the campaigns highlighted ongoing need for education to address mistaken beliefs among some parents about the hazards of second-hand smoke for children, and that there were clear limits to what could be achieved through educational approaches alone: children continue to be reliant on parents and carers to voluntarily adopt smoking restrictions to protect them from second-hand smoke.
The campaign evaluations also measured support among parents who smoked for bans on smoking in cars when children are present. A large majority were ‘in favour’ or ‘strongly in favour’ of bans (88%; 85%; 87%).4 These results are consistent with past surveys of the Cancer Council WA and other agencies.5,6,7
In Australia, laws prohibiting smoking in vehicles carrying children have been successfully introduced in South Australia and Tasmania with progress on legislation being made, or intentions to introduce or consider legislation announced, in almost every other state and territory.
Prior to the 2008 State Election, Western Australia's Labor Government announced its intention to ban smoking in cars carrying children. Despite Labor's election loss, the issue has remained on the political agenda. An Independent Member's Bill was tabled in November 2008 and passed in September 2009 prohibiting smoking in cars carrying children, among other measures.
We are in no doubt that a combination of ongoing well-funded public education campaigns on the hazards of smoking and second-hand smoke (the Quit Campaign), together with legislation and opportunistic advice by health professionals who deal with parents and smokers, is likely to be most effective in promoting the smoke-free message and encourage parents to quit smoking or desist from smoking near children if unable to quit.